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WHAT’S HAPPENING WEDNESDAY Kansas Immunization Program
June 10, 2020
On July 1, 2020 all influenza vaccine from the 2019-2020 influenza season will be expired. This means that some clinics may have remaining, expired flu vaccine on hand. What do you do with expired publicly-funded vaccine? That is a common question from vaccine providers. On page 29 of the Kansas Immunization Program (KIP) Vaccines For Children (VFC) Policy and Procedure Manual, information on the vaccine return process is outlined.
Any vaccine that has expired or spoiled needs to be removed from the vaccine storage unit and labeled “DO NOT USE.” This vaccine should be returned to the central vaccine distributor, McKesson. Vaccine cannot be returned to McKesson prior to the expiration date. See page 5 for directions on requesting a vaccine return. Be sure to report the expired vaccine in KSWebIZ within 72 hours.
Also, just a reminder about vaccine borrowing as it relates to seasonal influenza vaccine. Borrowing is permitted only in rare, unplanned circumstances. VFC providers participate in influenza vaccine pre-book early in any given year for the upcoming flu season. The amount of flu vaccine that is ordered via the KIP is what has been allotted for each VFC clinic for the entire flu season. Sometimes additional doses of flu can be ordered depending on the total flu allocation that Kansas receives.
VFC providers are allowed to borrow private flu vaccine to vaccinate VFC-eligible children when publicly-funded vaccine is not available. The private flu vaccine can be replaced once the VFC vaccine arrives. This one-directional borrowing is unique to seasonal influenza vaccine only. To ensure repayment of flu vaccine, do not plan on borrowing more private flu vaccine than was ordered during the flu pre-book, unless additional VFC vaccine is available.
Brad Carpenter, Vaccine Coordinator, can help answer these and other vaccine supply questions. Brad can be reached at 785-296-1948 or via email at [email protected]. Please let us know if we can help with any questions or concerns.
In This Issue
Chief Chat
Page 1
Injection of Education Page 2
Epidemiology Notes Shutting the Door on HPV Cancers
Page 3
Meningococcal B Reminder
KSWebIZ Bug Page 4
Requesting A Vaccine Return Page 5
Tuberculosis Tidbit Page 6
KIP-KIS Webinar Page 7
The Consultant On-Call can be reached Monday—Friday, 8 a.m.—5 p.m. at 785-296-5592.
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Childhood and adolescent immunization rates have seen a drastic decrease due to COVID-19. On May 24, 2020 the KIP What’s Happening Wednesday Chief Chat highlighted a drop in Vaccines for Children vaccine orders, showing an overall drop in ordering of 56%. The Centers for Disease Control and Prevention (CDC) published a Morbidity and Mortality Weekly Report (MMWR), Effects of the COVID-19 Pandemic on Routine Pediatric Vaccine Ordering and Administration, also showing a drastic decrease in vaccine orders. Now that counties are beginning to phase out of the stay-at-home orders, it is the perfect time to review patients in need of or overdue for vaccinations, schedule them to receive those vaccinations, and protect them from vaccine preventable diseases. Reminder/Recall is an excellent way to determine which children or adolescents (even adults) seen within your practice are due or overdue for vaccinations. The May 24, 2020 What’s Happening Wednesday included instructions for running Reminder/Recall Reports in KSWebIZ. You can also use your EMR or EHR to generate reminder/recall.
Summer is always busy with a rush of children and teens needing required vaccinations prior to the start of the new school year. This year, with the decrease in immunization rates, we will see this even more. School nurses across Kansas have recently sent out notifications to parents of vaccine requirements and doses needed prior to the beginning of the 2020/2021 school year. Determining which children or adolescents are in need of vaccines and scheduling them now, will decrease the number of those needing to be seen in July and August. What can you do? Begin now to advertise that you are open and available for immunization appointments. Encourage and reassure parents that your practice is open and that it is safe to bring their children or adolescents in to be seen. Parents also need to know that vaccine preventable diseases are still a threat and vaccinations are the best way to protect their children and adolescents. The American Academy of Pediatrics has launched a campaign to remind parents of the need for vaccinations “using humor and real-world conversations.” The American Academy of Family Physicians also stresses the importance of communicating with parents to decrease concerns, and offers immunization resources and other materials to help with those conversation. The CDC’s Information for Pediatric Healthcare Providers offers guidance for identification of children who have missed well-child visits. Each of these resources can be used to help your staff think of some creative ways to identify those needing vaccinations, develop ways to contact and schedule those patients, all while understanding and addressing patient and parent concerns. Happy vaccinating!
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This educational module was developed for health provider audiences with the goal of increasing HPV vaccination rates. In this module you will be able to: • Explain why HPV vaccine is important enough to be
routinely recommended for young people (i.e., HPV cancer prevention).
• Give an HPV vaccination recommendation that is effective and succinct using the same way, same day approach to the introduction of HPV vaccine.
• Answer the most frequently asked questions about HPV vaccine accurately and succinctly.
During the COVID-19 pandemic, Kansas has seen a significant decrease in publicly-funded
vaccines ordered and administered. The decrease in vaccines ordered was discussed briefly in
the May 27, 2020 edition of What’s Happening Wednesday.
Now to examine the decrease in the total number of vaccine doses administered. Using
KSWebIZ data, vaccine doses administered in 2020 were compared to doses administered
during the same time period in 2019.
• There was a 15% decrease in doses administered in March 2020 compared to March
2019.
• There was a 46% decrease in doses administered in April 2020 compared to April
2019.
• There was a 33% decrease in doses administered in May 2020 compared to May
2019.
While we are starting to make progress in catching up on missed immunizations, overall there
have been 72,000 fewer doses administered from March to May 2020 compared to the same
time frame the previous year.
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An issue with the vaccine inventory reconciliation process has been identified, which affects KSWebIZ direct entry providers only.
Problem:
When the vaccination date of an individual record is updated on the edit immunizations screen, after initially being entered, the date is not updating on the reconciliation transaction inquiry to decrement the inventory on the correct date.
Corrective Action Needed:
If an immunization was input with the incorrect date, delete the immunization and re-enter it with the correct date. This will allow the reconciliation transaction inquiry to remove the incorrect date of vaccination, adding it back to the inventory so it can be decremented on the correct date when it is re-entered.
If you need assistance with deleting an immunization, please contact the KSWebIZ Helpdesk at 877-296-0464 or [email protected]
KSWebIZ has identified an issue with the new Meningococcal B (MenB) recommendation that was part of the last KSWebIZ upgrade. KSWebIZ is auto-adding the precaution/contraindication “patient seeks protection” to all patients 16 to 24 years of age, allowing the Meningococcal B series to be recommended for these patients. The initial recommended immunization for all patients that have not been vaccinated with Men B currently shows Men B FHbp (Trumenba). Subsequent doses of Men B for each individual will be recommended based on what was actually given for the initial vaccination. Please be aware that the Kansas Immunization Program does not endorse Trumenba over Bexsero; it is the decision of the provider on which vaccine is ordered and administered. We are working with our vendor to correct this issue and will send an update once a resolution is in place. Please contact the KSWebIZ Help Desk for any questions or concerns. We apologize for any misunderstanding or inconvenience this may have caused.
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In February 2020, the CDC published the following MMWR regarding LTBI treatment: https://www.cdc.gov/mmwr/volumes/69/rr/rr6901a1.htm?s_cid=rr6901a1_w. In this guidance the CDC no longer recommends 6 or 9 months of Isoniazid (INH) as first line LTBI treatments. Providers should utilize once weekly Isoniazid and Rifapentine (3HP) for 12 weeks or 4 months of daily Rifampin as first line therapies. If the patient is unable to tolerate either treatment or has contraindications to treatment with either regimen it is acceptable to use one of the INH regimens.
Later in March 2020, the U.S. Food and Drug Administration (FDA) announced that Rifapentine (Priftin) was on allocation with intermittent supply available due to an increased demand for the drug. Due to the COVID-19 pandemic, the Kansas Tuberculosis Control Program (KS TB Program) has not been approving new 3HP treatments, so the shortage has not had a major impact on the state.
As we begin reopening and resume treatment of LTBI, it is important to be aware of the shortage and its impact on the recent update to LTBI treatment regimens. During the shortage, 3HP usage is limited and 4 months of daily Rifampin should be used for treatment of LTBI in the state of Kansas. Upon resolution of the Rifapentine shortage, normal 3HP usage will resume following regular protocols outlined by the KS TB Program.
If there is a strong clinical indication to treat with 3HP rather than 4 months of Rifampin (i.e. patient has contraindications to Rifampin) please submit the standard 3HP application form (https://www.kdheks.gov/tb/download/3HP_Policy_and_forms.pdf) along with provider notes stating the need for 3HP treatment. These applications will be reviewed according to standard protocol and clinical necessity.
We at the KS TB Program appreciate all your hard work and dedication throughout these unprecedented times and hope to return to normal processes soon. For any questions, comments or concerns please contact Kimberly Winans Tuberculosis Nurse Consultant ([email protected]), or Lisa Edgerton-Johnston Public Health Educator ([email protected]).
Date
Thursday, July 16, 2020
Conference Host
University of Kansas Medical Center
Conference Name
KIP/KIS Session 7.16.30 - TBD
Time
12:00 PM - 1:00 PM
Conference Location
Webinar, Webinar, KS
Provider
University of Kansas Medical Center
Presentation #1
Topic - Advances in Autism research and talking points of parents refusing vaccines
Credit Designation
• The University of Kansas Medical Center Office of Continuing Medical Education designates this live activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
• The University of Kansas Medical Center designates this live activity for a maximum of 1 Attendance w/ No Credit.
• APRNs/Nurses: The University of Kansas Medical Center Area Health Education Center East is approved as a provider of CNE by the Kansas State Board of Nursing. This course offering is approved for 1 contact hour(s) applicable for APRN, RN, or LPN relicensure. Kansas State Board of Nursing provider number: LT0056-0749. Mary Beth Warren, MS, RN, Coordinator.
• The University of Kansas Medical Center Office of Continuing Medical Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
ACCREDITATION STATEMENT
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GENERAL INFORMATION
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