Post on 05-Sep-2020
Decreasing vaccine preventable diseases in adults
Bruce Gellin, MD, MPHDeputy Assistant Secretary for Health
Director, National Vaccine Program OfficeUS Department of Health and Human Services
Joint Regional Meeting For the Americas and Europe
Madrid, SpainFebruary 1, 2017
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
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POLICIES THAT ENABLE SEASONAL INFLUENZA
VACCINE UPTAKE
• 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– 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– 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 ScheduleUnited States - 2016
0
50
100
150
200
250
300
1964 1974 1984 1994 2004 2006 2008
Year
Mill
ion
s
HR Adults 19-49
Adults > = 50 years
Children 6mo-18 yrs
24-59 mos. of age
6-23 mos. of age
50-64 year healthy individuals
Household contacts
Health care workers
Nursing home residents
Pregnant women
<65 years with a high risk
condition
> =65 years
Evolution of Seasonal Influenza Vaccination Recommendations – United States
2010: Flu vaccine recommendedfor all > 6 months of age
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 ScheduleUnited States - 2016
Surveillance of Vaccination Coverage
Among Adult Populations — United States,
2010-2014
February 5, 2016
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/448406/hpr2615_ppv.pdf
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/448407/hpr2615_shngls.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)
United States
• Assess• Recommend• Administer or Refer• Document
Assess
Recommend
Administer or Refer
Document
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
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
Vaccine hesitancy, acceptance and demand
Howard takes all of the flu shots that other employees refuse to take