November 4, 2013 Minutes

Coalitions Conference Call

Pharmacists and Immunization, HealthMap Vaccine Finder, and Partner Updates

Agenda Item 1: Pharmacists’ Role Within the Immunization Neighborhood
Featured SpeakerMitchel C. Rothholz (Mitch), RPh, MBA, chief strategy officer, American Pharmacists Association

Please see the accompanying slide deck for more detail on all these points.
Mitch discussed the role of the pharmacist within the “immunization neighborhood.” Some of the main points:

  • There has been much growth in the number of states authoring pharmacists to vaccinate (pharmacists can administer influenza vaccine in 52 states/territories). The ability to administer other vaccines varies by state and scope (antigens, age of patients, via protocol/Rx, etc.). The number of pharmacists trained to administer vaccines is more than 230,000.
  • The pharmacist certificate training program includes information for vaccines across the lifespan. Even if pharmacists are not authorized to provide all vaccines now, they can provide education and guidance to entire families and caregivers.
  • Pharmacy vaccination has some unique contributions, including access, proximity, and extended hours, and the ability to identify patients at risk for complications from vaccine-preventable diseases, based on their medications.
  • The ultimate goal for all immunization stakeholders, including pharmacists, is to be part of the “immunization neighborhood” — built around collaboration, coordination, and communication among immunization stakeholders. It doesn’t matter who gives the vaccination, just that the patient gets vaccinated and that it gets documented.
  • Revisions to the Adult Immunization Standards were recently approved by the National Vaccine Advisory Committee (NVAC). A recent survey of pharmacists regarding the proposed revised adult immunization standards identified areas for work by the profession (many would not be different from other health professions too). These areas include: assess immunization status and recommendations at every visit, confirm recommended vaccines received, establish referral relationships, understand how to access registries, and include immunization discussion in patient encounters.
  • Today we have good vaccines and multiple access points–need more collaboration on improving public health.
  • Pharmacists use a variety of protocol models. Most operate under protocols (like other health professions); some states require a prescription for specific vaccines or patients (e.g., certain age).
  • Pharmacists are encouraged to “walk the walk” and get vaccinated themselves. APhA house of delegate policy supports annual influenza vaccination as a condition of employment, training, or volunteering within an organization that provides pharmacy services or operates a pharmacy or pharmacy department (unless a valid medical or religious reason precludes vaccination).
  • Examples of practical pharmacy collaborations: incorporating influenza vaccination within diabetes care, Tdap vaccination of an infant’s family members, helping to ensure that the 3-dose HPV series is completed.
  • Travel health is a field of possible new growth and outreach, helping communities expand access to these services.
  • Immunization registries are a challenge for pharmacists as states have different administrative and data requirements (e.g., agreements must be signed between each individual pharmacy (not the corporate chain) and the registry, additional data required on top of minimum dataset, requirements for accessing data, etc.).
  • Another challenge is compensation.
  • Conclusion: Every patient encounter provides an opportunity to educate and advance immunization status.

Please see Mitch’s slide deck slide deck for more details.

  • Question #1: Any suggestions on how to get pharmacists involved in local immunization coalitions?
    Mitch suggested three approaches: 1) Reach out to the state pharmacy association, 2) Find which pharmacists are known locally as being immunization experts/advocates, 3) Contact local colleges/schools of pharmacy.
  • IAC’s Dr. Deborah Wexler suggested that coalitions wanting local leads contact Mitch directly.

  • Question #2: How can pharmacies better work with state immunization registries?
    Mitch said it is important to remember that everyone is working toward the same goal–a seamless interchange of information. Eventually with more universal electronic medical record use, data transfer will be easier. There are a number of steps that are being worked on. Examples of problems: some registries don’t accept information from pharmacies, some don’t track adult immunization.

Mitch encouraged people to contact him with questions on this presentation, or for ideas on how immunization coalitions can work with pharmacists in their areas.
Email Mitch Rothholz.

Agenda Item 2: HealthMap Vaccine Finder: Connecting Adults to Crucial Immunizations
Featured Speaker: Jane Huston, MPH, Boston Children’s Hospital /Harvard Medical School

Please see the accompanying slide deck for more detail on all these points.
Some of the main points from Jane’s presentation about the development and use of the HealthMap Vaccine Finder:

  • HealthMap is as an online, automated research tool to search for news related to disease outbreaks. The system searches all available sources including news organizations, RSS feeds, blogs, Twitter, and more for mentions of disease outbreaks related to animal, plant, and human health.
  • In 2009, due to the outbreak of H1N1 influenza, Google started a service called Flu Vaccine Finder that helped the public find a source of influenza vaccination.
  • In 2012, Google wanted to retire this service but HHS and CDC wanted it to survive. HealthMap agreed to take it over.
  • Members of the public who go to can click on a red box that asks “What Vaccines Do I Need?” This directs to two quizzes–one for all adult vaccines, and one for influenza vaccine only.
  • Clicking on a vaccine leads to information about basics of the disease and vaccine(s), including a link to the VIS. After looking up such information or taking one of the assessment quizzes, the user can click to find a provider in their geographic area.
  • The system also offers a rebuilt “shortage reporter” where consumers can report experiences when they were not able to get vaccinated due to lack of vaccine. The system makes a note on the map and sends an email to the provider to verify.
  • Provider recruitment is ongoing. To enter your information, click on “About” on the home page and then the “Register” button. Need to set up password-protected account. Can update info during year. Totally free. The system currently has approximately 46,000 locations; most are pharmacies. A goal is to increase the variety of providers; more health departments have been joining.
  • During the first year of operation, the system hosted 500,000 visitors (mostly in January when H1N1 was active). So far this fall, use is up 80% for the time period. The system can also specifically track what vaccines users are looking for.
  • Widgets are available to place on your website to direct people to the Vaccine Finder.
  • Facebook page
  • Twitter account @vaccinefinder
  • Question #1: What is the difference between the Flu Finder and Vaccine Finder widgets?
    Jane explained that both widgets would bring users to the same home page. The service started as Flu Finder and is gradually moving to the more inclusive Vaccine Finder name/service.
  • Question #2: How does Vaccine Finder use Twitter?
    Jane explained that Twitter is used in two ways: 1) To promote the HealthMap Vaccine Finder, and 2) HealthMap generally uses Twitter as a method of disease tracking for the research side.
  • Question #3: Where can patients find affordable hepatitis B vaccine?
    Jane said that VaccineMap does collect information on cost, but participating providers are not required to list cost. If a user clicks on a vaccine source, the cost information will appear if it is available.
  • Question #4: Does HealthMap help people without insurance?
    The system does collect information on whether or not insurance is accepted, but not on specific plans. Some sources do offer reduced fee vaccines, and providers can mark if a vaccine is offered for free. Future goals include recruiting more sources of lower-cost vaccination such as health departments and a way to filter results by affordability.

Please see Jane’s slide deck slide deck for more details.
Email Jane Huston.


Agenda Item 3: Announcements from Partners
  • Sara Jaye Sanford, Within Reach Washington, announced that the 11th National Conference on Immunization and Health Coalitions, “Partnering for Prevention from Sea to Summit,” will take place in Seattle from May 21–23, 2014. The planners are accepting abstract submissions until December 6.
  • Gigi from San Diego announced that HEP DART 2013 will take place in Hawaii, December 8-12, 2013.
  • Karen Ernst, Voices for Vaccines, encouraged people to register for a call on November 5 featuring Curtis Brainard, contributing editor at the Columbia Journalism Review. Brainard has written extensively about how journalists handle stories about immunization.
  • Joanne Sullivan, Pennsylvania Immunization Coalition, invited interested people to attend their regional meeting on December 3 at Lehigh University. Keynote speaker, Arthur L. Caplan, PhD, director, Center for Vaccine Ethics & Policy, New York University, Langone Medical Center, will address the topic of “Vaccine Mandates for Healthcare Providers.” About 100 seats are available; email Joanne if you are interested in attending.


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