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October 2007 NVAC Meeting Minutes - page 9 / 40





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October 2007 NVAC Meeting Minutes

should not be vaccinated even though this is not necessarily a contraindication to vaccination.

The study also identified another barrier to vaccinationa lack of regular well-care visits. According to the study, HCPs are more likely to discuss vaccinations with patients during well-care visits than during acute-care visits. Finally, the study also found that cost was not cited very often as a major barrier to vaccination; however, cost was more of an issue for uninsured individuals.

Dr. Johnson concluded his presentation by mentioning some strategies to increase immunization rates, such as increasing awareness and knowledge among consumers and HCPs, encouraging HCPs to make adult immunizations a part of their routine, and expanding first-dollar insurance coverage. Dr. Johnson believed these strategies should be the subject of discussion for NVAC.


Dr. Jaime Fergie began the discussion by focusing on the differences between consumer perceptions and HCPs’ perceptions of consumer perceptions. For example, he mentioned the discrepancy in terms of side effects of the influenza vaccine. Dr. Fergie wondered if HCPs might be using this as an excuse not to worry about vaccinations. Dr. Johnson agreed that the discrepancy between the perceptions was big. However, he did mention that some of the more than 2,000 consumers that were surveyed were going to doctors, thus influencing HCPs’ perceptions of consumer beliefs, while others were not going to the doctor. Therefore, there are two different populations of consumers. Dr. Lowell followed up by mentioning that physician distraction was not included in the study. He explained that distraction is a factor that has to be contented with as it is the reality of what physicians face when trying to treat patients.

Dr. Gordon reflected on earlier comments on the broad definition of the flu. He explained that physicians know that the influenza vaccine is not completely effective; therefore, they may be reluctant to administer the vaccine due to concerns about consumer satisfaction. He wondered what the probability was that a physician would recommend a patient get the flu vaccine and that that patient would get what they thought was the flu. Dr. Schuchat responded that even during the middle of a typical flu season, the majority of “influenza-like illness” is not influenza viruses.  The proportion of ILI clinical specimens tested that are positive for influenza rarely exceeds 30% during the peak weeks of the season, as many other respiratory pathogens cause similar syndromes.

CDC Grantee Immunization Program Guidelines and Activities for Adult Immunization—Nancy Fasano

Ms. Nancy Fasano began her presentation by explaining that the Program Operations Branch is the primary point of contact within CDC for the 64 immunization grantees, which are the 50 States, 6 select cities, and 8 island grantees. This branch develops the program announcement and annual grant guidance and makes the funding recommendations for 317 operations, 317 vaccine purchase, and the VFC operations awards.

Ms. Fasano described the funding opportunity announcements, which are the framework for each 5-year project period. Adult immunization is one of 10 program components that applicants must address. The 2008–12 funding announcement included three requirements related to adult immunization having to do with evidence-based approaches to increasing vaccination, the influenza vaccination of healthcare workers, and increasing access to vaccine for high-risk adults.

The Immunization Program Operations Manual is a companion document to the program announcement. The manual describes in more detail the specific expectations of the grantees. It describes 18 recommended activities related to the three requirements for adult immunizations. Activities related to

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