Prevention and Public Health Fund “Nevada Adult Immunization Partnership & Improvement Project”
Outline ■ Adult immunizations overview ■ Standards for Adult Immunization ■ Nevada overview ■ Grant goals, objectives and activities ■ Resources ■ Q and A
Adults Need Shots too? ■ Healthy adults largely unaware they should be seeking vaccination – Think vaccines are for kids, old people, or those with poor health – Haven’t heard about other vaccine-preventable diseases (whooping cough, shingles, HPV, etc.) that affect adults ■ Not getting recommendations for vaccination from their healthcare professionals ■ Adult vaccination services beyond influenza/pneumococcal may not be offered by all healthcare providers ■ The role of pharmacies in adult vaccination expanding (beyond flu) ■ Vaccinations are increasingly offered at work and community sites
Adult Vaccines ■ Influenza (flu) ■ Td or Tdap ■ Zoster ■ Pneumococcal ■ Other vaccines are determined by factors such as: – Health conditions (e.g., diabetes, heart disease) – Job (e.g., healthcare worker) – International travel – Vaccine history
Adult Immunization Disparities ■ Lower vaccine coverage among Hispanics and African Americans compared to non-Hispanic Caucasians – Uninsured – Lower incomes – For newly insured adults ■ – Affordable Care Act (ACA) requires non-grandfathered private plans to include coverage for ACIP-recommended vaccines – Especially important to conduct assessment among newly insured
Adult Immunization Standards ■ Stresses that all providers, including those that don’t provide vaccine services, have a role in ensuring patients are up-to-date on vaccines ■ Acknowledges that: – Adult patients may see many different healthcare providers, some of whom do not stock some or all vaccines – Adults may get vaccinated in a medical home, at work, or retail setting ■ Aim is to avoid missed opportunities and keep adult patients protected from vaccine-preventable diseases ■ Calls to action for healthcare professionals – Assess immunization status of all patients in every clinical encounter. – Strongly Recommen mmend vaccines that patients need. – Admini inister needed vaccines or Refe fer to a provider who can immunize. – Documen ment vaccines received by patients, including entering immunizations into immunization registries
What Can We Do as a Community? ■ Create an environment that encourages adults to: – Set an example for others by educating themselves about recommended vaccines – Ask healthcare providers or pharmacists about what vaccines are needed – Be persistent in seeking vaccination as not all healthcare providers offer vaccination ■ Remind family, loved ones, and co-workers about the importance of being up-to-date on vaccines that adults need ■ Improving frequency of vaccine assessment and recommendations may help reduce disparities ■ Get involved with the Adult Immunization Task Force!
Nevada Grant Background ■ Nevada law mandates entry of vaccine administration into NV WebIZ (Nevada’s SIIS) for both adults and children ■ Nevada continues to have high uninsured rates and low vaccination rates for adults Nevada is ranked 46 th for primary care physicians per capita ■ ■ 36% of Nevadans and 2/3 of rural-frontier residents live in a primary care HPSA ■ Nevada has a projected 17% increase by 2017 in population aged 65 years and older ■ Nevada’s Asian population has increased by 116% and its Hispanic population by 82% ■ Nevada Pharmacists are currently vaccinating: From April 1, 2014 – March 31, 2015, 270,406 vaccines were administered
Overall Project Goal ■ Nevada Adult Immunization Partnership & Improvement Project Improve knowledge and expand implementation of The Standards for Adult Immunization (aka “Standards”), increase usage of 317-funded vaccines for eligible groups and increase overall adult immunization rates by at least 2%.
Objectives ■ Increase the number of clinic sites implementing the Standards ■ Improve the ability and process to provide vaccines on-site or the ability and process to refer to other provider sites ■ Improve and expand the ability and practice of providers to routinely and accurately document adult vaccinations in Nevada WebIZ ■ Develop and implement strategies to best utilize available Section 317 vaccine to expand access to uninsured adults ■ Increase the amount of quality, adult vaccine-related online resources ■ Increase social marketing in adult vaccine promotion and disease prevention
Activities ■ Hire Adult Immunization Coordinator to work at the State level and a Southern Nevada Adult Outreach Nurse to work in Clark County. ■ Convene Adult Immunization Task Force with 4 subcommittees: – Community Health Centers, FQHC and Health Districts – Pharmacies – Large Healthcare Systems – Nonprofit, Community and Faith-based ■ Distribute online Knowledge, Attitudes, Beliefs, and Behaviors (KABB) survey ■ Collaborate with HealthInsight QIN-QIO on reducing disparities and improving immunization rates and assessment of immunization status for Nevada Medicare beneficiaries.
■ Provider Education Activities – Develop and distribute Adult Immunization Toolkit (customized for each target group) – Develop AFIX model for participating providers – Provide reminder/recall cards and postage where necessary – Conduct continuing education via webinar and in-person summit ■ Community Activities – Develop communications plan for community, online and clinic-level consumer health information resources – Promote 317 Vaccine access points to eligible adults
Evaluation ■ Number of pharmacies, community health centers and healthcare systems participating in project and related data ■ Types and amount of information distributed; web page visits; social media metrics and media impressions Measureable outcomes in alignment with Healthy People 2020 goals. These include, but are not limited to: ■ Influenza: Increase the percentage of adults aged 18 years and older and pregnant women who are vaccinated annually ■ Pneumococcal: Increase the percentage of adults; noninstitutionalized adults aged 65 years and older; noninstitutionalized high-risk adults aged 18 to 64 years; and institutionalized adults (persons aged 18 years and older in long-term or nursing homes) who are vaccinated ■ Zoster: Increase the percentage of age-appropriate adults who are vaccinated
Next Steps – Immediate Future ■ Hire and train the contracted State employee ■ Convene the initial Task Force, develop the meeting schedule and create the Work Groups – Respond to post-webinar email form! http://goo.gl/forms/wjxt68vg0i ■ Develop and distribute the pre-project “KABB” survey ■ Gather baseline rates using NV WebIZ data
Resources ■ CDC handouts for providers about how to implement the Standards cdc.gov/vaccines/hcp/adults/for-practice/standards/index.html ■ National Foundation for Infectious Diseases adultvaccination.org ■ American College of Obstetricians and Gynecologists immunizationforwomen.org ■ American Pharmacists Association pharmacist.com/immunization-resources ■ National Adult Immunization Plan hhs.gov/nvpo/national-adult-immunization-plan
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