Estimated HPV vaccination coverage for 1+ dose, ages 19-26, United - - PowerPoint PPT Presentation

CDC 2016 National Health Interview Survey (NHIS)

H U M A N PA P I L L O M A V I R U S

100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%

Percent Vaccinated

Estimated HPV vaccination coverage for 1+ dose, ages 19-26, United States, NHIS data, 2012-2016

2012 2014 2015 2016

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

V accines protect the individual and the community V accine-preventable diseases have no age limits V accines available specifically for adults Missed immunizations or waning immunity from prior vaccinations The immune system declines with age Even healthy people can get sick Certain settings may require immunization as part of employment

www.cdc.gov/vaccines/adults/reasons-to-vaccinate.html www.nlm.nih.gov/medlineplus/ency/article/004008.htm

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.

Impact of Vaccine-Preventable Diseases in the United States

Herpes Zoster (Shingles)1

Annually ,there are about 1 million cases of shingles Lifetime risk is ~33%

Human Papillomavirus (HPV)2

Nearly 80 million Americans are currently infected with HPV (~14 million new infections each year)

Every year in the US, causes

• ver

33,700 cancers in men and women

Pneumococcal Disease3

About 900,000 people get pneumococcal pneumonia every year

Leads to as many as 400,000 hospitalizations and ~3,700 deaths,(>95% deaths among adults)

Hepatitis B4

Between 850,000 to 2.2 million people suffer from chronic Hepatitis B Complications can include liver damage,cirrhosis, liver cancer ,and even death

Influenza5,6

12,000 to 56,000 deaths per year (71- 85% among adults 65+) 140,000 to 710,000 hospitalizations per year (54-70% among adults 65+)

It is estimated that at least 45,000 adult deaths occur as a result of vaccine-preventable diseases each year .

3www.cdc.gov/pneumococcal/about/facts.html#ref2 4www.cdc.gov/hepatitis/hbv/bfaq.htm#bFAQb03 5www.cdc.gov/flu/about/disease/2015-16.htm 6www.cdc.gov/flu/about/disease/65over.htm 1www.cdc.gov/shingles/hcp/clinical-overview.html 2www.cdc.gov/hpv/parents/questions-answers.html

Vacci Vaccine ne Recommendati tions

Recommended Adult Immunizations

Influenza Tdap/Td MMR VAR RZV or ZVL HPV PCV13 and HepA PPSV23 HepB MenACWY MenB Hib Influenza Tdap/Td MMR VAR RZV or ZVL HPV PCV13 and PPSV23 HepA HepB MenACWY MenB Hib

Recent Changes to ACIP Adult Schedule

Zoster1

• 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).

MMR2

• 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.

HPV3

• 2 or 3 doses depending on age at series initiation

1www.cdc.gov/mmwr/volumes/67/wr/mm6703a5.htm 2www.cdc.gov/mmwr/volumes/67/wr/mm6701a7.htm 3www.cdc.gov/mmwr/volumes/65/wr/mm6549a5.htm

Recent Changes to ACIP Adult Schedule

Hepatitis B1

• 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

Flu2

• CDC/ACIP renewed the recommendation to include LAIV as an available option for the

2018-19 flu season

MPSV43

• This vaccine is no longer available and has been removed from the adult schedule

1www.cdc.gov/mmwr/volumes/67/wr/mm6715a5.htm 2www.cdc.gov/mmwr/volumes/67/wr/mm6722a5.htm 3www.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

www.cdc.gov/vaccines/pregnancy/index.html

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 .

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

www.cdc.gov/vaccines/hcp/patient-ed/conversations/downloads/vacsafe-ensuring-bw-office.pdf



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)

Immun unizati tion Co Cove verage Ra Rates es

www.cdc.gov/vaccines/imz-managers/coverage/adultvaxview/pubs-resources/NHIS-2016.html

*FluVaxView †AdultVaxView ‡MMWR Surveillance Summaries / May 5, 2017 / 66(11)

44.0% 43.3% 65.5% 65.3% 66.5% 72.4% 25.6% 32.7% 13.2% 19.9% 53.5% 60.3% 36.9% 48.7% 22.5% 31.8% 48.5% 13.5%

70% 90% 30%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 18+Years 65+Years 65+Years 18+Years 65+Years 18+Years 65+Years 60+Years Female, 19-26 Years Male, 19-26 Years Flu (2016-17)* Pneumococcal (2016)† Tdap (2016)† Td orTdap (2016)† Zoster (2014)† HPV 1+ dose (2016)‡

S U M M A R Y

Percent vaccinated

Estimated proportion of adults ≥18 years who received selected vaccines, by age group— NHIS and BRFSS data, United States and New Jersey , 2014–2017

New Jersey United States HP 2020 Target

NJ HPV data not available for this age group at this time

Healthy New Jersey 2020

2016 = 66.5% 2016 = 60.9%

https://nj.gov/health/chs/hnj2020/health/immunization/index.shtml

I N F L U E N Z A

CDC Behavioral Risk Factor Surveillance System (BRFSS),available at FluV axView 70% 60% 50% 40% 30% 20% 10% 0% 80% 100% 90%

2010-2011 2011-2012 2012-2013 2013-2014

18-64

2014-2015

65+

2015-2016 2016-2017 Percent Vaccinated

Estimated influenza vaccination coverage, by age group, New Jersey , BRFSS data, 2010-2017

18+ 18-49 50-64 Healthy People 2020 Target = 70% (Adults 18+) Healthy NJ 2020 Target = 70% (Adults 65+) Age Group (in years)

New Jersey Behavioral Risk Factor Survey Data Influenza V accination in Last Y ear Age 50+, Age-adjusted 2016

https://www26.state.nj.us/doh-shad/query/result/njbrfs/ImmFlu1Yr/ImmFlu1YrAA11_.html

County-Level Flu Data

I N F L U E N Z A