October 2007 NVAC Meeting Minutes
NCIRD collaborates with each of its branches on various immunization activities. The Assessment Branch uses various platforms to periodically assess vaccination coverage, such as the National Immunization Survey (NIS), the National Health Interview Survey (NHIS), and the Behavioral Risk Factor Surveillance System (BRFSS). The Education, Information, and Partnership Branch produces net conferences, satellite broadcasts, podcasts, and educational materials on immunizations, and the Health Services Research and Evaluation Branch plans to conduct a focus group to evaluate the adult immunization schedule.
NCIRD also works with the Immunization Information Systems Support group to discuss how immunization registries can be used to track adult immunization coverage. NCIRD provides information, support, collaboration, and coordination for National Influenza Vaccine Week. They also conduct seasonal influenza activities and qualitative research on factors influencing the immunization of healthcare workers and barriers to vaccination. Within CDC, NCIRD works most closely with the Division of Adult and Community Health, specifically with their Healthy Aging Program.
The Center’s funding comes from the section 317 program as there is no VFC program for adults. The section 317 program provides funding for vaccines that can be used for uninsured and underinsured adults.
Dr. Charles Lovell, Jr., asked why there is such a difference in terms of CDC’s infrastructure for adult immunizations versus pediatric immunizations. He wondered if CDC considered adult immunizations to be less important than pediatric immunizations. Dr. Schuchat responded by explaining that the provider is a very important part of the infrastructure and that most healthcare providers for adults do not provide immunizations. She went on to explain that CDC administers the VFC program and that it is CDC’s responsibility to purchase the VFC vaccines and make sure they get to the providers in both the public and private sector.
Dr. Pavia noted that the American College of Physicians (ACP) published the “Green Book” approximately 18 years ago; it contained guidelines on adult immunizations. He explained that a group of individuals is working with ACP to try to get them more actively involved in adult immunizations again. The goal is to work with ACP—and probably CDC and the ACIP as well—to revise the “Green Book.”
Dr. Gary Urquhart (NCIRD) noted that that 70 percent of CDC’s grantees have the capability of tracking adult immunizations.
Dr. Hinman followed up on Dr. Pavia’s comments by explaining that it is his understanding that the ACP is now formally endorsing the adult immunization schedule, which it had not been doing in the past.
Adult Immunization at CMS—Dr. Jeffrey A. Kelman
Dr. Jeffrey A. Kelman began his presentation by explaining that CMS has a two-sided interest in vaccines, Medicaid and Medicare. Medicaid is usually discussed in terms of the VFC program and section 317 funding; therefore, the focus of the presentation was on Medicare.
There have been many changes to Medicare this year. Part B, which covers posttreatment exposure and specific preventive vaccines, will remain essentially unchanged in 2008. There will be changes under the part D vaccination program, which includes preventive vaccines.