August 7, 2013 Minutes

Coalitions Conference Call

Flu Update, Documentary Invisible Threat, and Partner Updates

Agenda Item 1: Influenza Vaccination for the 2013-2014 Season
Speaker: Litjen (L.J) Tan, MS, PhD, chief strategy officer, Immunization Action Coalition – Access Dr. Tan’s slide deck.

Wrap-up of 2012-13 Influenza Season

  • The 2012-13 influenza season was moderately severe. There were 158 pediatric deaths; approximately 90% of the children with known vaccination status were not vaccinated. Additionally, more than 64% of the children were over the age of 5, and only 48% had a high risk condition.
  • H7N9 virus first reported in China on March 31. New cases have dropped dramatically since a major effort by the Chinese government to stop transmission of the virus. This virus is different than the H5N1 viruses that have infected humans in that the virus is only lowly pathogenic in birds and thus does not kill the birds. This makes detection of the virus in poultry more difficult. So far, there has been no confirmed human-to-human transmission and poultry is believed to be the source of human infection. Watching closely in fall 2013.
  • Preliminary estimates of influenza vaccine coverage for the 2012-13 season: children (54.9%), adults (35.1%), healthcare personnel (70.5%), pregnant women (53%).
  • Adjusted vaccine efficacy in 2012-13 against influenza A and B was 53%. Efficacy against influenza type A was lower in those over age 65 years (27%). It’s important to realize that vaccination does not just reduce disease incidence, but it also reduces the number of outpatient medical visits, hospitalizations, and disability in the elderly.

2013-14 Season

  • New formulation and abbreviations: introduction of inactivated influenza vaccine – quadrivalent (IIV4). Inactivated influenza vaccine – trivalent is now abbreviated IIV3. All LAIV (FluMist) will be quadrivalent.
  • New technology: first cell culture-based vaccine in the U.S. (ccIIV), brand name Flucelvax; and first recombinant vaccine in the U.S. (RIV), brand name Flublok. RIV is a trivalent vaccine made with a totally egg-free process, and is recommended by the ACIP for vaccination of people age 18-49 years with egg allergy of any severity.
  • Other returning influenza vaccines include Fluzone ID (intradermal delivery) and Fluzone HD (4 times the amount of antigen, indicated for age 65 and older). IAC has a table of influenza vaccines available for the 2013-14 season and their indications.
  • Other than recommending RIV for people with egg allergy, CDC has no other preferential recommendations.
  • The pediatric algorithm for children age 6 months through 8 years who need 2 doses of vaccine has not changed from last year.
  • Need to focus on increasing vaccination coverage among all people age 6 months and older, especially adults in certain racial and ethnic groups, healthcare personnel (especially those working in long-term care facilities and non-pharmacists, physicians, and nurses), and pregnant women.
  • Another issue to assess is the role and effect of complementary providers and partners providing influenza vaccination, including pharmacy, community immunizers, occupational health immunizers, and obstetrical providers. Need to keep communication open.
  • Need continue looking at vaccine efficacy and duration (i.e., is waning immunity a problem?)
  • The web-based Influenza Vaccine Locator is back for a second year and includes ALL adult vaccines. Practices are encouraged to sign up at This resource is powered by HealthMap from Harvard University.
  • We now have a routine universal recommendation which simplifies the messaging. However, the multiple vaccine types will complicate the quest for clear and unified guidance and messaging.

A question was asked about whether all 250,000 doses of Flublok would expire at the same time (Flublok has a 16-week shelf life.) Dr. Tan subsequently contacted the manufacturer, and they anticipate releasing the first lots in mid to late October, and the next series one month later.
Dr. Tan also encouraged people to contact him with questions on this presentation, or to sign up to get on the National Influenza Vaccine Summit mailing list for updates on influenza news.

Email Dr. Litjen (L.J) Tan.

Agenda Item 2: Invisible Threat Documentary
Speaker: Lisa Posard, executive producer of Invisible Threat, a new documentary on the anti-vaccine movement

Please see the accompanying slide deck for more detail on all these points.
Invisible Threat is a 40-minute documentary made by award winning high school students in San Diego. Originally intended as a short film about the vaccines recommended for teens, the movie took on a different focus when the students became personally aware of anti-vaccine movement. Lisa Posard of chstvFILMS was the executive producer.
Lisa requested help in launching the film in a coordinated manner around the nation via local screenings of the film through an online movement called Gathr.Us ( This crowdsourcing initiative is the same process that launched the highly successful film Girl Rising, which is now featured on CNN. National coordination is necessary so that the anti-vaccine forces do not have access to the film prior to screening and rally against it. A unified approach will also help coalitions develop messages to accompany this important film and potentially generate local media interest in the work of the sponsoring coalitions.
The producers need commitments from organizations to host Gathr.Us screenings in regions around the nation at the same time. The way Gathr.Us works is that after you agree to host a screening, the Gathr.Us site will facilitate the online selling of tickets to the screening. Once the critical mass of ticket sales is reached, the screening will be held and all ticket purchasers will be charged. If a threshold number of tickets is not sold, then the screening will not be held, and no ticket purchaser will be charged.
In rural areas without a theater, Gathr.Us will set up the screenings at community centers, churches, auditoriums, etc. Those types of screenings generally only need about 30 tickets to be sold to be an approved site.
PTAs, Rotary clubs, etc. can be involved in promotion and selling tickets.
A related curriculum for high school students will also be made available, with teen-led advocacy social media follow-up efforts, including a magazine-style blog, Twitter, and Facebook. Lisa said that teens are very susceptible to anti-vaccines messages because they get their information from electronic sources.
The proposed time for the launch would either be in October or January (not the holiday period). Looking for feedback from coalitions on this.
Many national organizations have endorsed this film. The producers are looking for more endorsements.
If your coalition is interested in sponsoring a screening of Invisible Threat, want to provide an official endorsement from your organization, or if you just need more information, please email the executive director, Lisa Posard at
If you haven’t viewed Invisible Threat yet, here is the information that allows you to do so. Please do not give out the links and passwords to the complete movie to anyone outside your group! The film is copyrighted and cannot be screened prior to the official launch. As mentioned before, if the film leaks out, the anti-vaccine forces will have time to protest it and ruin the premiere. Finally, if the film should be screened at an event or posted publicly prior to the launch, it negates ANY opportunity for using Gathr.Us, and jeopardizes any national press interest. SO AGAIN, PLEASE DO NOT SHOW THIS FILM PUBLICLY PRIOR TO LAUNCH and please don’t share this with others who are not involved in your coalition. It is of critical importance that the film doesn’t get shown to audiences before the official launch.
Here is the link to the 3-minute film trailer:
password: science
Here is the link to the full film and password:
password: science
Email Lisa Posard.


Agenda Item 3: Announcements from Partners
Catherine Flores Martin, director, California Immunization Coalition, announced that the VICNetwork would be sponsoring a webinar on August 27 about influenza vaccination messaging. The call will feature Kristine Sheedy, PhD, and Yvonne Garcia, both of CDC’s National Center for Immunization and Respiratory Diseases. For more information, visit


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