Download Decreasing vaccine preventable diseases in adults

Decreasing vaccine preventable diseases in adults
Joint Regional Meeting
For the Americas and Europe
Madrid, Spain
February 1, 2017
Bruce Gellin, MD, MPH
Deputy Assistant Secretary for Health
Director, National Vaccine Program Office
US Department of Health and Human Services
https://www.hhs.gov/nvpo
The vision for the Decade of Vaccines (2011–2020) is of a world in which all
individuals and communities enjoy lives free from vaccine-preventable diseases.
The mission of the Decade of Vaccines is to extend, by 2020 and beyond, the full
benefit of immunization to all people, regardless of where they are born, who
they are or where they live.
13. CONSIDERS that an evidence-based,
cost-effective, safe and efficient
immunization system is an integral part of
a well-functioning health system.
December 2014
14. POINTS OUT that, given the changes in
the demographic structure of the European
population, there must be a greater focus
on preventing infectious diseases by means
of vaccination of all age groups where this
improves the epidemiological control of
the disease.
December 2014
SEASONAL INFLUENZA VACCINE
DOSES DISTRIBUTED 2004-2013 (PER 1,000)
Palache 2015
SEASONAL INFLUENZA VACCINE
DOSES DISTRIBUTED 2004-2013 (PER 1,000)
Palache 2015
SEASONAL INFLUENZA VACCINE
DOSES DISTRIBUTED 2004-2013 (PER 1,000)
Palache 2015
SEASONAL INFLUENZA VACCINE
DOSES DISTRIBUTED 2004-2013 (PER 1,000)
Palache 2015
SEASONAL INFLUENZA VACCINE
DOSES DISTRIBUTED 2004-2013 (PER 1,000)
?
Palache 2015
POLICIES THAT ENABLE SEASONAL INFLUENZA
VACCINE UPTAKE
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Vaccine advocacy and education
Building public trust
Real-time management of the vaccination program
Political commitment
Improving access to vaccination
Palache 2015
POLICIES THAT ENABLE SEASONAL INFLUENZA
VACCINE UPTAKE
• Vaccine advocacy and education
– For general public, high risk groups, vaccinators
• Building public trust
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Adverse event monitoring
Disease surveillance
Program impact assessment
Communication
• Real-time management of the vaccination program
– Monitor coverage in real time
– Continuous quality improvement
• Political commitment
– Prioritize influenza within health portfolio
• Improving access to vaccination
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Reduce restrictions to access
Reduce financial disincentives
Reconsider age limits of older populations
Provide monetary incentives to vaccinators
Palache 2015
Member States Recommending
Seasonal Influenza Vaccination for Adults
Recommended Adult Immunization Schedule
United States - 2016
Evolution of Seasonal Influenza Vaccination
Recommendations – United States
HR Adults 19-49
300
Adults > = 50 years
250
Children 6mo-18 yrs
24-59 mos. of age
Millions
200
6-23 mos. of age
150
50-64 year healthy individuals
Household contacts
100
Health care workers
50
Nursing home residents
Pregnant women
0
1964 1974 1984 1994 2004 2006 2008
Year
2010: Flu vaccine recommended
for all > 6 months of age
<65 years with a high risk
condition
> =65 years
Impact of Policies (and their adoption)
Seasonal Influenza Vaccine Production, Distribution: United States 1979-2010
(millions of doses)
Outreach and Reminder Recall
“We ask that you confirm your risk category for flu….”
Recommended Adult Immunization Schedule
United States - 2016
February 5, 2016
Surveillance of Vaccination Coverage
Among Adult Populations — United States,
2010-2014
Percentage PPV coverage –ever vaccinated, by age group, England,
2005/06 to 2014/15
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/448
406/hpr2615_ppv.pdf
Cumulative shingles vaccine coverage in England by age cohort, September
2014 to May 2015 (year 2), and September 2013 to August 2014 (year 1)
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/448407/hpr2615_shngls.pdf
United States
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•
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Assess
Recommend
Administer or Refer
Document
 Assess
 Recommend
 Administer or Refer
 Document
Adult Vaccination Finder
Available at http://www.vaccines.gov/
National Immunization
Awareness Month
• In August;
third week
focuses on
adults
• Highlights
value of
vaccines
across the
lifespan
Toolkit available at: www.nphic.org/niam
http://www.izsummitpartners.org/
Maternal Immunization
Sobanjo-ter Mullen (VRBPAC, 2015)
Global Impact of AMR
by 2050
300 million people are
expected to die prematurely
because of drug resistance
GDP will shrink by 2 to 3.5%
Global economy will lose
between 60 and 100 trillion
USD worth of economic output
http://amr-review.org/
Vaccines prevent infections
and so reduce the need to use
antibiotics
This is true for vaccines that prevent bacterial
infections, and it is also true for vaccines that
prevent viral infections, such as the flu, which
should not be treated with antibiotics but often
are anyway. This may be for lack of rapid
diagnostic tests to inform prescription or
because patients buy them over the counter.
Vaccines also have the
potential to reduce the use of
antibiotics in agriculture
February 2016
Recommendations
• Use existing products
more widely in humans
and animals
• Renew impetus for early
research
• Sustain a viable market for
needed products
February 2016
Four Overarching Goals
THE NATIONAL VACCINE PROGRAM OFFICE
Epilogue….
…and Prelude
Vaccine hesitancy, acceptance and demand
16. RECOGNISES the importance of the
general public understanding the value of
vaccinations and NOTES that the occasional
lack of awareness of the benefits of some
vaccines and the increasing refusal of
vaccination in some Member States may
lead to under-vaccination in some
populations resulting in public health
problems and costly outbreaks.
December 2014
Howard takes all of the flu shots that other employees refuse to take