Estimated HPV vaccination coverage for 1+ dose, ages 19-26, United States, NHIS data, 2012-2016 100% H U M A N PA P I L L O M A V I R U S 90% 80% 70% Percent Vaccinated 60% 50% 40% 30% 20% 10% 0% 2012 2014 2015 2016 CDC 2016 National Health Interview Survey (NHIS)
Road Map for Success: Adult Immunizations Christina G. Tan, MD MD, MPH State Epidemiologist/Assistant Commissioner Division of Epidemiology, Environmental & Occupational Health New Jersey Department of Health
Disclaimer • I have no financial interests or other relationships with the manufacturers of commercial products, suppliers of commercial services, or commercial supporters. Planners have reviewed content to ensure there is no bias. • This presentation will not include any discussion of the unlabeled use of a product or a product under investigational use.
Overview IMMUNIZA TION BASICS VACCINE RECOMMENDA TIONS IMMUNIZA TION COVERAGE RA TES ADUL T IMMUNIZA TION ST ANDARDS & STRA TEGIES NJDOH INITIA TIVES
Imm Immun unizati tion Ba Basics ics
WhyVaccinate? Herd Immunity www.mlive.com/news/index.ssf/2014/12/how_do_vaccinations_work_the_s.html
www.theguardian.com/society/ng-interactive/2015/feb/05/-sp-watch-how-measles-outbreak-spreads-when-kids-get-vaccinated
Rationale for Adult Immunization Missed V accines protect the V accine-preventable immunizations or V accines available individual and the diseases have no age waning immunity specifically for adults community limits from prior vaccinations Certain settings may The immune system Even healthy people require immunization declines with age can get sick as part of employment We nee need to buil build on th the e suc uccess ss we ac achie ieved with th chil ildhood and adolescen ent immu mmuni niza zation cover verag age. www.cdc.gov/vaccines/adults/reasons-to-vaccinate.html www.nlm.nih.gov/medlineplus/ency/article/004008.htm
Impact of Vaccine-Preventable Diseases in the United States It is estimated that at least 45,000 adult deaths occur as a result of vaccine-preventable diseases each year . Human Herpes Zoster Pneumococcal Papillomavirus Hepatitis B 4 Influenza 5,6 (Shingles) 1 Disease 3 (HPV) 2 About 900,000 Nearly 80 million Between 850,000 12,000 to 56,000 Annually ,there are people get Americans are to 2.2 million deaths per year (71- about 1 million pneumococcal currently infected with people suffer from 85% among adults HPV (~ 14 million new cases of shingles pneumonia every chronic Hepatitis B 65+) infections each year) year Complications can 140,000 to Every year in the Leads to as many as include liver 710,000 400,000 US, causes over Lifetime risk is damage,cirrhosis, hospitalizations per hospitalizations and 33,700 cancers in ~33 % ~ 3,700 deaths,(>95% year (54-70% among liver cancer ,and men and women deaths among adults) adults 65+) even death 1 www.cdc.gov/shingles/hcp/clinical-overview.html 5 www.cdc.gov/flu/about/disease/2015-16.htm 3 www.cdc.gov/pneumococcal/about/facts.html#ref2 2 www.cdc.gov/hpv/parents/questions-answers.html 4 www.cdc.gov/hepatitis/hbv/bfaq.htm#bFAQb03 6 www.cdc.gov/flu/about/disease/65over.htm
Vacci Vaccine ne Recommendati tions
Recommended Adult Immunizations Influenza Tdap/Td MMR VAR Influenza Tdap/Td MMR VAR PCV13 and PCV13 and RZV or ZVL HPV HepA RZV or ZVL HPV HepA PPSV23 PPSV23 HepB MenACWY MenB Hib HepB MenACWY MenB Hib
Recent Changes to ACIP Adult Schedule Zoster 1 • Administer 2 doses of recombinant zoster vaccine (RZV , Shingrix) 2 – 6 months apart to adults aged 50 years or older regardless of past episode of herpes zoster or receipt of zoster vaccine live (ZVL, Zostavax). • Administer 2 doses of RZV 2 – 6 months apart to adults who previously received ZVL at least 2 months after ZVL. • For adults aged 60 years or older , administer either RZV or ZVL (RZV is preferred). MMR 2 • Administer 1 dose of MMR to adults who previously received ≤ 2 doses of mumps-containing vaccine and are identified by a public health authority to be at increased risk during a mumps outbreak. HPV 3 • 2 or 3 doses depending on age at series initiation 1 www.cdc.gov/mmwr/volumes/67/wr/mm6703a5.htm 2 www.cdc.gov/mmwr/volumes/67/wr/mm6701a7.htm 3 www.cdc.gov/mmwr/volumes/65/wr/mm6549a5.htm
Recent Changes to ACIP Adult Schedule Hepatitis B 1 • On February 21, 2018, the ACIP recommended Heplisav-B (HepB-CpG), a yeast-derived vaccine prepared with a novel adjuvant, administered as a 2-dose series (0, 1 month) • For use in persons aged ≥ 18 years who are previously unvaccinated or incompletely vaccinated Flu 2 • CDC/ACIP renewed the recommendation to include LAIV as an available option for the 2018-19 flu season MPSV4 3 • This vaccine is no longer available and has been removed from the adult schedule 1 www.cdc.gov/mmwr/volumes/67/wr/mm6715a5.htm 2 www.cdc.gov/mmwr/volumes/67/wr/mm6722a5.htm 3 www.cdc.gov/vaccines/schedules/hcp/adult.html#changes
Available at:www.cdc.gov/vaccines/schedules/hcp/imz/adult.html
Available at:www.cdc.gov/vaccines/schedules/hcp/imz/adult-conditions.html
Vaccines During Pregnancy Flu Whooping cough (Tdap) CDC has developed resources for pregnant women,healthcare providers, and families and caregivers on the importance and safety of vaccination during pregnancy . www.cdc.gov/vaccines/pregnancy/index.html
Travel Vaccines Certain vaccines are available to protect against some diseases that may be encountered during travel. CDC quiz to determine which vaccines may be needed based on country of travel: www.cdc.gov/travel/destinations/list
Vaccine Safety Vaccines are one of the most convenient and safest preventive care measures available. Vaccines are monitored before and after licensure to ensure that they are safe and effective. Any adverse events can be reported to the Vaccine Adverse Event Reporting System (VAERS) www.cdc.gov/vaccines/hcp/patient-ed/conversations/downloads/vacsafe-ensuring-bw-office.pdf
Immun unizati tion Co Cove verage Ra Rates es
www.cdc.gov/vaccines/imz-managers/coverage/adultvaxview/pubs-resources/NHIS-2016.html
Estimated proportion of adult s ≥ 18 years who received selected vaccines, by age group — NHIS and BRFSS data, United States and New Jersey , 2014 – 2017 100% 90% 90% 80% 70% 70% NJ HPV data not available for Percent vaccinated this age group at this time 60% S U M M A R Y 50% 40% 72.4% 66.5% 65.5% 65.3% 60.3% 30% 30% 53.5% 48.7% 48.5% 44.0% 43.3% 36.9% 20% 32.7% 31.8% 25.6% 22.5% 19.9% 13.2% 13.5% 10% 0% 18+Years 65+Years 65+Years 18+Years 65+Years 18+Years 65+Years 60+Years Female, 19-26 Male, 19-26 Years Years Flu Pneumococcal Tdap Zoster HPV 1+ dose Td orTdap (2016 )† (2016-17)* (2016 )† (2016 )† (2014 )† (2016 )‡ New Jersey United States HP 2020 Target *FluVaxView † AdultVaxView ‡ MMWR Surveillance Summaries / May 5, 2017 / 66(11)
Healthy New Jersey 2020 2016 = 66.5% 2016 = 60.9% https://nj.gov/health/chs/hnj2020/health/immunization/index.shtml
Estimated influenza vaccination coverage, by age group, New Jersey , BRFSS data, 2010-2017 100% 90% Healthy People 2020 Target = 70% ( Adults 18+ ) Healthy NJ 2020 Target = 70% ( Adults 65+ ) 80% I N F L U E N Z A 70% Percent Vaccinated 60% 50% 40% 30% 20% 10% 0% 2010-2011 2011-2012 2012-2013 2013-2014 2014-2015 2015-2016 2016-2017 Age Group (in years) 18+ 18-49 18-64 50-64 65+ CDC Behavioral Risk Factor Surveillance System (BRFSS),available at FluV axView
County-Level Flu Data New Jersey Behavioral Risk Factor Survey Data Influenza V accination in Last Y ear I N F L U E N Z A Age 50+, Age-adjusted 2016 https://www26.state.nj.us/doh-shad/query/result/njbrfs/ImmFlu1Yr/ImmFlu1YrAA11_.html
Recommend
More recommend
