Immunization Registry September 24, 2019 12:00 PM 1:00 PM Central - PowerPoint PPT Presentation

A Shot in the Arm for Immunization Registry September 24, 2019 12:00 PM – 1:00 PM Central

Webinar Objectives  Summarize the value of immunizations for personal and population health.  Recognize the role of the pharmacist for vaccination administration.  Prioritize immunization registry implementation. 2

Featured Presenters Stephan Schroeder, MD, CMD, CMQ Medical Director South Dakota Foundation for Medical Care Jeff Jacobson, Pharm D Southpointe Pharmacy, Fargo, ND Tammy LeBeau IIS Coordinator, South Dakota Department of Health 3

Vaccines in the Adult Immunization Schedule* Vaccines Abbreviations Trade names Haemophilus influenzae type b vaccine Hib ActHIB Hiberix Hepatitis A vaccine Hep A Havrix Vaqta Hepatitis A and hepatitis B vaccine HepA-HepB Twinrix Hepatitis B vaccine HepB Engerix-B Recombivax HB Heplisav-B Human papillomavirus vaccine HPV vaccine Gardasil 9 Influenza vaccine, inactivated llV Many brands Influenza vaccine, live attenuated LAIV FluMist Quadrivalent Influenza vaccine, recombinant RIV F lublok Quadrivalent M-M-R II Measles, mumps, and rubella vaccine MMR Meningococcal serogroups A, C, W, Y vaccine MenACWY Menactra Menveo Meningococcal serogroup B vaccine MenB-4C Bexsero MenB-FHbp Trumenba Pneumococcal 13-valent conjugate vaccine PCV13 Prevnar 13 Pneumococcal 23-valent polysaccharide vaccine PPSV23 Pneumovax Tetanus and diphtheria toxoids Td Tenivac Td vaccine Tetanus and diphtheria toxoids and acellular pertussis vaccine Tdap Adacel Boostrix Varicella vaccine VAR Va riv ax Zoster vaccine, recombinant RZV Shingrix Zoster vaccine live ZVL Zostavax *Administer recommended vaccines if vaccination history is incomplete or unknown. Do not restart or add doses to vaccine ser ies for extended int e rv als be tw een do se s. Th e u se of trade nam es is for identification purpo se s only and does not imply endor se me nt by th e ACIP or CD C. 4

~ ~ ~ ~ :1:00 so - 75 ND *' KS Qr 47 % 47.JIJEJ 44.9% 41. ll!Jti 50 L... v I I > I I I 8 25 0 States :1:00 so 75 *' 53.9% Qr 50 L... v I I I I I 8 25 0 States :1:00 FtuVax\tiiew lr lllluenzaVacd nation Rates for 6 mo11ths oldier , 2015 - 201 1 6 so 75 6;6% Qr 50 L... v ' ' I I 8 25 0 States httpd Jwww.cdc.gov/flufflUVIDNiew/report:shtmlltrends/index.htm l 5

2017-2018 Flu Season: Flu Burden and Flu Burden Averted by Vaccination 2811-2818 n1 ...... ....... CIC 11111111111111 amll: 960,000 19,000 49m ill io n flu illnesses flu deaths f lu hospitalizati ons weru Wllblut n1 ncclnes. Tiiis llVll'I 1111111ceuld11111 •n llPflllllltllV 48% 81 die l.S. IOPUllU. ClllSe 18 let I n1 ncelne during Ille 2011-2011 nu -. 1111lhls1nnt11111111 est1m1t8d: 109,000 8,000 1 mi ll io n flu Illnesses, flu deaths, flu hospitalizations, about the population or about the number ol vehides twiOe the number or hospitals in crossing the Golden Ga:e Bridge lhe United Sta1es . New York City each day 1111111111111 l11111Ct II mere llllerlcaa clllSe 11111 1 Ill vaccine. 1anv mere nu mHSSn. nu Ms111111Z1d111 and nu dlllas e11111111 lrlV911et 6

3~t9 ~ Figure 2. Early and End-of-Season Flu Vaccination Coverage Among Adu l ts , United States, 2014-November 20 8 - E rty-23Son es mate (based on IFS ) -E -sas estimate (bas e on BRFSS .. "'O 60 " "' ·- c w > 43 .6 7 Ii ... ID c: " ... v 40.4 " • com ared o t • differ 20 20 s- 6 014-15 2016 -17 2017-18 01 9 F tu S on 7

Basics of Immunization Information Systems (llSs) Parents and general public Doctors and health care Public he alth uses the informa- use the information to enroll providers use llSs to determine tion to develop programs that children in sc hools and day care which vaccinations are needed increase vaccination coverage and to determine if they need and to care for patients. and decrease the harm caused vaccinations. by vaccine-preventable diseases. 8

Role of the Pharmacist in Vaccination Administration

Origins  APhA first guidelines in 1997  Originally began in 2002 in ND through NDSU • 20 hour course for certification • Renew every 2 years

Origins  Written protocol agreement with physician or nurse practitioner  Valid Prescription Order  All vaccinations in ages 11 and up  Flu vaccination in ages 8 and up originally • Currently ages 5 and up can be vaccinated

Pharmacists Role  Improve Vaccination Rates through: • Access • Education

Access  Numerous pharmacies in the state  Walk in basis  Extended hours  Copay at time of vaccination

Education  Provide education in person/on phone • Stress importance of vaccinations • Combat misconceptions  Access to NDIIS allows us to discuss forecasted immunizations

Insurance Coverage  Determining Insurance coverage • Commercial Insurance • Part B • Part D • Medicare Advantage Plans

Insurance Coverage  Commercial • Anyone not covered by Medicare • Formulary coverage • Administration fee

Insurance Coverage  Medicare Part B covers the following immunizations: ● Hepatitis B vaccine (for patients at high or intermediate risk) ● Influenza virus vaccine ● Pneumococcal pneumonia vaccine ● Vaccines directly related to treatment of an injury or direct exposure to a disease or condition

Insurance Coverage  Medicare Part D potentially covers any vaccinations not covered by Part B • Shingrix  Even some that could be covered by Part B • Pneumococcal – Advantage Plan • Tetanus – depends on vaccination (Part D) or injury (Part B)

Pharmacist’s Value  Per Drug Topics October 2016, adult flu vaccinations in US pharmacies rose from 6% in 2004 to 25% in 2015  Increase in vaccination rates from all causes not just pharmacies • Years 2000-2016 Influenza ages 18 and older from 28.7% to 40.9 • Years 2000-2016 Pneumo ages 18 and older from 15.4% to 22.9%

Pharmacists Value  Lessen the burden on providers and nursing staff  More access and education = higher vaccination rates

SOUTH DAKOTA IMMUNIZATION INFORMATION SYSTEM SDIIS Statewide Immunization Information System – web based real time exchange:

OVERVIEW  SDIIS was implemented in 1995 as a dial upsystem Converted to a web application in 2005  Current Status: Over 1,160,000 Patient Records   14,863,340 Individual Shots Recorded  1162 Facilities Actively Utilizing the SDIIS  310 Facilities connected via HL7 bi-directional Interface Over 5500 individual users 

BENEFITS  Sharing of Immunization Records Complete Immunization History   Recommend Functionality  Reminder/Recall  Vaccine Ordering Functionality Vaccine Management  Vaccine Recall   Immunization Coverage Reports  Missed Opportunities

TYPES OF FACILITIES UTILIZING SDIIS  Clinics Hospitals   Pharmacies  Nursing Homes  Schools/Colleges Adjustment Training Centers/DOC  Daycare Centers/Head Start   Out of State Clinics/schools bordering South Dakota

CONTACT INFORMATION Tammy LeBeau Radhika Saripalli Tammy.lebeau@state.sd.us Radika.Saripalli@state.sd.us 605-773-4783 605-773-7473

Kansas IIS Contact Kansas Immunization Program WebIZ Immunization Helpdesk – 877-296-0464 Email – kdhe.ImmunizationRegistry@ks.gov http://www.kdheks.gov/immunize

Nebraska IIS Contact Ernad Klipic NE Department of Health and Human Services Phone: 402-471-1448 Email: Ernad.Klipic@nebraska.gov NeSIIS Help Desk: (888) 433-2510 http://dhhs.ne.gov/Pages/Immunization.aspx

North Dakota IIS Contact Molly A. Howell ND Department of Health, Disease Control Phone: 701-328-4556 Email: mahowell@nd.gov http://www.ndhealth.gov/Immunize/NDIIS/

South Dakota IIS Contact Radhika Saripalli South Dakota Department of Health Phone: 800-592-1861 Email: Radhika.saripalli@state.sd.us https://doh.sd.gov/family/childhood/immunizati on/

A Shot in the Arm for Immunization Registry September 24, 2019 12:00 PM – 1:00 PM Central https://greatplainsqin.org