Wisconsin Council on Immunization Practices Meeting
March 11, 2016
Madison Water Utility
119E. Olin Ave, Madison, WI
Topics Discussed
2015-2016 Influenza Season
Update-Tom Haupt-Stated we are approaching the peak of influenza season,11 pregnant women have been hospitalized, only 4 of them had received the flu vaccine. The population being most affected (71%) is the 18-64 year olds. H1N1 has been the predominant strain; no pediatric deaths in WI at this time, also seeing RSV, Human Metapneumovirus; and Rhino-Enterovirus.
WI Vaccination Rates- Ashley Petit-Summary data was presented for the influenza season in the registry thus far. There are more doses of vaccines documented in the registry at this same time versus last year at this time. In reviewing the past four years of data, the immunization program is seeing a trend of decrease in vaccination of the 0-4 year old population.
Dr. Temtecommented that we still need to do a better job with immunizing the school age kids-(the largest population of spreaders of the disease).
Zika Update- Tom Haupt-In WI, 217 people have been tested; 159 asymptomatic pregnant women have been tested; A positive Zika IGM needs to have further testing (complicated diagnosis). Symptoms could be indicative of other diseases (Dengue and Chikungunya). Transmission has occurred in semen. It is not known how long Zikz is transmitted in semen-at least 62 days or greater.
Elizabethkingia-Tom Haupt-This is a rare bacterium which causes a blood stream infection- WI has had 48 cases (15 people have died); DPH still doesn’t know the source, CDC has sent people to WI to help with trying to determine source. The majority of the cases were in January. Four cases were just diagnosed this week.
DPH Staffing Updates- Stephanie Schauer --Sally Roepe (WI Association of School Nurse representative)and Pam Applebee (DPH Medicaid Program representative)will both be transitioning off of WCIP,
Ashley Petit, State Immunization Program epidemiologist will be leaving the program.
2015 VPD Cases- Stephanie Borchardt-A handout was given regarding 2015 surveillance of vaccine preventable diseases in Wisconsin.
VFC Update- Jackie Nelson-
Meningococcal B vaccine is available through VFC ordering. 73 VFC providers have ordered this vaccine; ~1900 doses have been distributed.
Flu prebook-The Immunization program has 20,000 less doses flu ordered for the 2016-2017 flu season as compared to previous years. In 2015, 52 LHD did mass clinics. 50 LHDs will be participating 2016. Pick n Save has contacted the Immunization program requesting to administer VFC flu in the 2016 flu season. (They have potentially 70 pharmacies-The Immunization program will probably provide VFC vaccine to some of the sites, but not all- Looking to allow administration in areas where there aren’t many other providers of vaccine).
VFC Tdap cocooning program at birthing hospitals will be discontinued as of 3/31/16. In 2015, hospitals administered approximately 10,000 of VFC provided Tdap doses. Some hospitals will continue with cocooning on their own.
DPH Adult Immunization Grant – Stephanie Borchardt—The Adult Immunization grant from CDC focuses on assessment, recommendation and administration of vaccines to adults; as well as documentation into WIR.
Activities:
a)There will probably be an Adult Immunization summit this fall.
b) LHD/Tribes have been sent template objectives to increase Adult Immunization rates.
c) The Immunization program will also be offering funding to the 17 immunization coalitions in the near future as well.
February ACIP Report- Dr. Jon Temte gave highlights of the meeting:
-ACIP discussed that Merck has presented to FDA to drop HPV9 from 3 doses to 2 doses
-The stage is being set for a recommendation to use Meningococcal vaccine with populations who are HIV positive and also men who have sex with men.
-Influenza -Voted to let live attenuated influenza vaccine be given to those with egg allergies.
Adolescent Tdap Dose- Stephanie Schauer- The School Immunization law requires kids to receive their Tdap booster as they enter 6th grade. Although these kids are seeing their provider the summer prior to entering 6th grade, they may not yet be 11 years old. Many providers will not give the vaccine until they are age 11. The parent then opts to sign the personal conviction waiver, so they are compliant for school. A discussion was had regarding the following problem.
Meningitis B –Ashley Petit-Data was presented regarding the update of Meningococcal B in WIR. At this time, 1250 doses have been entered into the registry.
-Currently Meningococcal B shows in WIR forecasting once it is given-“Invoke on Use”. There was much discussion regarding if it should be “Invoke on Age” or “Invoke on Use”.
Some WCIP memberswere pro “Invoke on Age” and some were pro “Invoke on Use”.
This vaccine was recommended by ACIP as a Category B vaccine.
Category A recommendations are made for all persons in an age- or risk-factor-based group.
Category B recommendations are made for individual clinical decision making.
Dr. Temte referred back to ACIP’s reasoning on this vaccine.
“The current low prevalence of disease, coupled with the fact that important data for making policy recommendations for MenB vaccines are not yet available, resulted in ACIP determining that insufficient evidence exists to make a routine public health recommendation that all adolescents be vaccinated with MenB vaccine. Given the seriousness of meningococcal disease and the availability of licensed vaccines, ACIP agreed that sufficient evidence exists to encourage individual clinical decision making.” MMWR-Weekly “Use of Serogroup B Meningococcal Vaccines in Adolescents and Young Adults: Recommendations of the Advisory Committee on Immunization Practices, 2015” October 23, 2015/64(41);1171-6
No decision was made on making a change at this time.
HPV–Sarah Born addressed current activities around the CDC grant.
-Coalition grant work ends Oct 2016.
-Social media campaigns were thought to be a successful outreach. The efforts focused on: “Jackie’s story”; The cancer prevention aspect of the vaccine; The use of teens faces. The Immunization Program may do this again in the Fall.
-Postcards -18,000 will be sent out around the 11thyear birthdays of those born in Jan, Feb, and March.
-AFIX staff have done 50 site visits so far.
-The State Immunization Program will be direct funds to purchase a license to show the video “Someone you Love: the HPV Epidemic”.
-There are two HPV summits planned-May 11in Wausau and May12 in Waukesha. Dr. Conway and Dr. Davis will be presenters.
Vaccine Manufacturer Updates-Updates were given by Merck, Sanofi, MedImmune, and GSK.
A presentation was given by GSK representative Dr. Len Friedland. He spoke to GSK’s work regarding pediatric flu vaccine and also regarding the utilization of adjuvants in vaccines.
These draft notes are prepared by Linda Schwobe RN, WALHDAB representative to WCIP
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