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October 2007 NVAC Meeting Minutes - page 34 / 40





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October 2007 NVAC Meeting Minutes

Dr. Dekker proposed that this be an area of emphasis for the February meeting and that she would invite an appropriate guest speaker to make a presentation on efforts to fight Staphylococcus infection. Dr. Gordon agreed but added that the National Vaccine Plan also should be addressed at the Subcommittee’s February meeting to ensure the Subcommittee maintains an ongoing role in its creation. Also, he said he hoped that additional NVAC members would join the Vaccine Development and Supply Subcommittee.

Dr. Baylor observed that he was not sure that the Subcommittee has a role with regard to Staphylococcus infection but that it “was in our face” right now. His concern was that any efforts at this point would simply be reactionary. Dr. Dekker again raised the point that these efforts might provide a template for how to address emerging infectious agents, and the meeting was adjourned.

Subcommittee on Immunization Coverage—Chair: Dr. Jon R. Almquist

Attendees: Dr. Faruque Ahmed, NCIRD/CDC; Dr. Guthrie S. Birkhead, New York State Department of Health (NVAC); Dr. Jeffrey A. Kelman, CMS; Dr. Charles Lovell, Jr., York Clinical Research (NVAC); Dr. Gina T. Mootrey, NCIRD/CDC; Dr. Walter A. Orenstein, Emory University School of Medicine; Dr. Wayne Rawlins, America’s Health Insurance Plans; Dr. Lance Rodewald, NCIRD/CDC; Dr. Jeanne Santoli, NCIRD/CDC; Dr. Phil Smith, NCIRD/CDC; Dr. Raymond A. Strikas, HHS; Dr. Gary L. Urquhart, NCIRD/CDC; Dr. Adele E. Young, George Mason University (NVAC); Melissa Athié, notetaker.

Dr. Jon R. Almquist began the Subcommittee meeting, per Dr. Gary L. Freed’s suggestion, by discussing what specific components of adult immunization the Subcommittee on Immunization Coverage may want to take on and/or address and by discussing what NVAC should be doing about adult immunization coverage, even if it does not specifically fall within the purview of this Subcommittee. Dr. Almquist opened up the floor for discussion on this issue.

Discussion on Subcommittee’s Role in Terms of Adult Immunizations

Dr. Charles Lovell, Jr., proposed looking at the public health sector as a source of immunizations for adults rather than the private sector. He wondered if patients should be directed to health departments for immunizations and if health departments should be provided with more education on adult immunizations. Because private offices are often overwhelmed, Dr. Lovell asked for feedback from the Subcommittee regarding what is the best site for administering adult immunizations.

Dr. Raymond A. Strikas responded by stating that no one site is best for administering adult immunizations. He explained that about half of all adults received their influenza (flu) vaccine at physicians’ offices and that a sizeable proportion received it in various other locations such as clinics and senior centers. He explained that the workplace is the second leading site for receiving the flu vaccine and that it is the chief site, for people under 50 years of age, to receive the flu vaccine. He did, however, recognize that this simply addresses the flu vaccine and not other adult vaccinations. Dr. Strikas contemplated how much more the public sector could do, in terms of adult immunizations, in addition to what they are already doing. He asked various CDC members to comment on what it would take to enhance the public sector and the nonphysician office sector as a venue for delivering vaccines to adults. He agreed that the workplace may be one of the most important options but that workplaces have experienced frustrations in the past due to flu vaccine supply shortages.

Dr. Almquist shared with the group that the Finance Working Group received a report stating that the large insurers were considering not involving the flu vaccine as it is cheaper for their members to go to locations such as Walmart and Costco to receive the vaccine. He explained that adults going to various

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