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October 2007 NVAC Meeting Minutes - page 10 / 40





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October 2007 NVAC Meeting Minutes

adult immunization are simply recommended while activities related to childhood immunization are required. This is a function of funding as the CDC has not had additional funding to provide for adult activities.

Ms. Fasano then provided information on the 2006 annual report that grantees submitted and the activities included in the previous funding announcement. Ms. Fasano said that outreach to the private sector by the grantees is very important. Every State has identified adult coordinators; however, specific funding for this position is not included in the awards. Therefore, some States can afford a full-time adult coordinator while others cannot.


Dr. Young asked how much funding is given to grantees as part of 317. Dr. Rodewald commented that the figure was around $190 million and that only 10 percent of that money was devoted to adult immunization activities. Dr. Walter A. Orenstein mentioned that it was interesting that some grantees are doing more than others in terms of adult immunizations. He wondered if they were able to go beyond the recommended strategies by using their own funds or if they were shifting their 317 funds from childhood to adult immunization activities. He also wondered if there was any correlation between those States that developed and implemented patient reminder and recall systems and their adult immunization coverage levels. Dr. Birkhead explained that New York uses a combination of 317 funding and State funds. New York also implemented a standing order statute for hospitalized patients so that it is now a requirement to offer the influenza vaccine during flu season. Dr. Hinman mentioned that the 317 Coalition is seeking to get funding under 317 increased almost twofold.

Summary of Adult Immunization Discussions and Proposed Next Directions for NVAC—Dr. Raymond A. Strikas

Dr. Strikas began his summary with the remark “Why can’t we treat adults like children?” He mentioned that there are higher rates of vaccine-preventable diseases in adults than there are in children.

He said that the solution rests with the provider or the system and not with the patient; it is much easier to influence a large number of providers than an even larger number of patients. However, there are limited Government resources for adult vaccinations. Dr. Strikas discussed the idea of having a report card for the Government, which was proposed by Dr. Pavia and Dr. Schwartz, to look at what CDC and CMS are doing. He commented that CMS uses pay-for-performance plans and wondered if that might work for immunization. He also suggested that the Committee could arrange to have speakers discuss issues regarding financing vaccination in adult practices. Dr. Strikas believed the Committee should look at what HRSA and the Bureau of Primary Health Care are doing about immunizations as well.


Dr. Freed noted that NVAC has not dealt substantively with adult immunization issues in the past. He asked that the various Subcommittees and Working Groups decide which issues they would take on and to report back tomorrow.

Dr. Feinberg mentioned two issues that the Committee did not touch on. The first is that there are an increasing number of elderly people in the United States, making these issues more important than ever. He also emphasized that it was important for the Committee to focus its discussions on items that can be addressed so as to not produce another report that does not make an impact. Dr. Humiston asked if the Committee needed a motion to create an Adult Immunization Working Group. Dr. Freed stated that rather than creating another Working Group and diluting the Committee’s resources, the Committee should

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