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Granade CJ, Crawford NE, Banks M, Graitcer S. Analysis of the Federal Section 317 Immunization Program and Routine Adult Immunization Activities, United States, 2022-2023. Public Health Rep 2024:333549241236085. [PMID: 38504465 DOI: 10.1177/00333549241236085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024] Open
Abstract
OBJECTIVES The federal Section 317 Immunization Program, administered by the Centers for Disease Control and Prevention (CDC), provides funding to support adult immunization efforts; however, current information on program implementation at the jurisdictional level is limited. We assessed the use of Section 317 and other funding sources to support routine adult immunization activities among the 64 immunization programs ("awardees"). METHODS We conducted a survey and key informant interviews with awardees in October to December 2022 to collect quantitative and qualitative data on current adult vaccine purchase and program operation activities funded by Section 317 and other funding sources. We assessed total vaccine cost and data on vaccine purchase projections for each awardee with CDC's Cost and Affordability Tool for 2023. RESULTS Immunization program managers or their designees from 62 of 64 awardees (97%) completed the survey; 12 awardees participated in key informant interviews. Of 62 awardees, 32 (52%) used a single funding source to support adult vaccine purchases, of which 29 (91%) used only Section 317 funds, 21 (34%) reported not planning to purchase ≥1 age-based recommended vaccine for adults in 2023, and 33 (53%) reported using Section 317 funds only to support adult immunization program operations. Key informant interviews showed varied operational activities among awardees, but 8 awardees stated the need for additional staff to expand adult immunization program services in health care provider education (n = 5), program administration (n = 5), and site visits (n = 6). CONCLUSIONS Additional efforts are needed to understand how to better support routine adult immunization activities implemented at the jurisdictional level.
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Affiliation(s)
- Charleigh J Granade
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Nathan E Crawford
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Michelle Banks
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sam Graitcer
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Jones CH, Jenkins MP, Adam Williams B, Welch VL, True JM. Exploring the future adult vaccine landscape-crowded schedules and new dynamics. NPJ Vaccines 2024; 9:27. [PMID: 38336933 PMCID: PMC10858163 DOI: 10.1038/s41541-024-00809-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/11/2024] [Indexed: 02/12/2024] Open
Abstract
Amidst the backdrop of the COVID-19 pandemic, vaccine innovation has garnered significant attention, but this field was already on the cusp of a groundbreaking renaissance. Propelling these advancements are scientific and technological breakthroughs, alongside a growing understanding of the societal and economic boons vaccines offer, particularly for non-pediatric populations like adults and the immunocompromised. In a departure from previous decades where vaccine launches could be seamlessly integrated into existing processes, we anticipate potentially than 100 novel, risk-adjusted product launches over the next 10 years in the adult vaccine market, primarily addressing new indications. However, this segment is infamous for its challenges: low uptake, funding shortfalls, and operational hurdles linked to delivery and administration. To unlock the societal benefits of this burgeoning expansion, we need to adopt a fresh perspective to steer through the dynamics sparked by the rapid growth of the global adult vaccine market. This article aims to provide that fresh perspective, offering a detailed analysis of the anticipated number of adult vaccine approvals by category and exploring how our understanding of barriers to adult vaccine uptake might evolve. We incorporated pertinent insights from external stakeholder interviews, spotlighting shifting preferences, perceptions, priorities, and decision-making criteria. Consequently, this article aspires to serve as a pivotal starting point for industry participants, equipping them with the knowledge to skillfully navigate the anticipated surge in both volume and complexity.
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Affiliation(s)
| | | | | | - Verna L Welch
- Pfizer Inc, 66 Hudson Boulevard, New York, NY, 10001, USA
| | - Jane M True
- Pfizer Inc, 66 Hudson Boulevard, New York, NY, 10001, USA.
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Surie D, Bonnell LN, DeCuir J, Gaglani M, McNeal T, Ghamande S, Steingrub JS, Shapiro NI, Busse LW, Prekker ME, Peltan ID, Brown SM, Hager DN, Ali H, Gong MN, Mohamed A, Khan A, Wilson JG, Qadir N, Chang SY, Ginde AA, Huynh D, Mohr NM, Mallow C, Martin ET, Lauring AS, Johnson NJ, Casey JD, Gibbs KW, Kwon JH, Baughman A, Chappell JD, Hart KW, Grijalva CG, Rhoads JP, Swan SA, Keipp Talbot H, Womack KN, Zhu Y, Tenforde MW, Adams K, Self WH, McMorrow ML. Comparison of mRNA vaccine effectiveness against COVID-19-associated hospitalization by vaccination source: Immunization information systems, electronic medical records, and self-report-IVY Network, February 1-August 31, 2022. Vaccine 2023:S0264-410X(23)00567-4. [PMID: 37301704 DOI: 10.1016/j.vaccine.2023.05.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Accurate determination of COVID-19 vaccination status is necessary to produce reliable COVID-19 vaccine effectiveness (VE) estimates. Data comparing differences in COVID-19 VE by vaccination sources (i.e., immunization information systems [IIS], electronic medical records [EMR], and self-report) are limited. We compared the number of mRNA COVID-19 vaccine doses identified by each of these sources to assess agreement as well as differences in VE estimates using vaccination data from each individual source and vaccination data adjudicated from all sources combined. METHODS Adults aged ≥18 years who were hospitalized with COVID-like illness at 21 hospitals in 18 U.S. states participating in the IVY Network during February 1-August 31, 2022, were enrolled. Numbers of COVID-19 vaccine doses identified by IIS, EMR, and self-report were compared in kappa agreement analyses. Effectiveness of mRNA COVID-19 vaccines against COVID-19-associated hospitalization was estimated using multivariable logistic regression models to compare the odds of COVID-19 vaccination between SARS-CoV-2-positive case-patients and SARS-CoV-2-negative control-patients. VE was estimated using each source of vaccination data separately and all sources combined. RESULTS A total of 4499 patients were included. Patients with ≥1 mRNA COVID-19 vaccine dose were identified most frequently by self-report (n = 3570, 79 %), followed by IIS (n = 3272, 73 %) and EMR (n = 3057, 68 %). Agreement was highest between IIS and self-report for 4 doses with a kappa of 0.77 (95 % CI = 0.73-0.81). VE point estimates of 3 doses against COVID-19 hospitalization were substantially lower when using vaccination data from EMR only (VE = 31 %, 95 % CI = 16 %-43 %) than when using all sources combined (VE = 53 %, 95 % CI = 41 %-62%). CONCLUSION Vaccination data from EMR only may substantially underestimate COVID-19 VE.
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Affiliation(s)
- Diya Surie
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States.
| | - Levi N Bonnell
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States; General Dynamics Information Technology, Falls Church, VA, United States
| | - Jennifer DeCuir
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Manjusha Gaglani
- Baylor Scott & White Health and Texas A&M University College of Medicine, Temple, TX, United States
| | - Tresa McNeal
- Baylor Scott & White Health and Texas A&M University College of Medicine, Temple, TX, United States
| | - Shekhar Ghamande
- Baylor Scott & White Health and Texas A&M University College of Medicine, Temple, TX, United States
| | - Jay S Steingrub
- Department of Medicine, Baystate Medical Center, Springfield, MA, United States
| | - Nathan I Shapiro
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Laurence W Busse
- Department of Medicine, Emory University, Atlanta, GA, United States
| | - Matthew E Prekker
- Department of Emergency Medicine and Medicine, Hennepin County Medical Center, Minneapolis, MN, United States
| | - Ithan D Peltan
- Department of Medicine, Intermountain Medical Center, Murray, UT and University of Utah, Salt Lake City, UT, United States
| | - Samuel M Brown
- Department of Medicine, Intermountain Medical Center, Murray, UT and University of Utah, Salt Lake City, UT, United States
| | - David N Hager
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Harith Ali
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Michelle N Gong
- Department of Medicine, Montefiore Health System, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Amira Mohamed
- Department of Medicine, Montefiore Health System, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Akram Khan
- Department of Medicine, Oregon Health and Sciences University, Portland, OR, United States
| | - Jennifer G Wilson
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Nida Qadir
- Department of Medicine, University of California-Los Angeles, Los Angeles, CA, United States
| | - Steven Y Chang
- Department of Medicine, University of California-Los Angeles, Los Angeles, CA, United States
| | - Adit A Ginde
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, United States
| | - David Huynh
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, United States
| | - Nicholas M Mohr
- Department of Emergency Medicine, University of Iowa, Iowa City, IA, United States
| | | | - Emily T Martin
- School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Adam S Lauring
- Departments of Internal Medicine and Microbiology and Immunology, University of Michigan, Ann Arbor, MI, United States
| | - Nicholas J Johnson
- Department of Emergency Medicine and Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA, United States
| | - Jonathan D Casey
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Kevin W Gibbs
- Department of Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Jennie H Kwon
- Department of Medicine, Washington University, St. Louis, MO, United States
| | - Adrienne Baughman
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | - James D Chappell
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Kimberly W Hart
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Carlos G Grijalva
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Jillian P Rhoads
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Sydney A Swan
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - H Keipp Talbot
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Kelsey N Womack
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Yuwei Zhu
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Mark W Tenforde
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Katherine Adams
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Wesley H Self
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, United States; Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Meredith L McMorrow
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
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