North Carolina

Association of Pharmacists

Meeting Name / Leader/ Facilitator / Location
NCIC / Responsibilities shared this mtg / Wake Med Cary Hospital
Conference Center, Cary NC
Date / StartTime / EndTime / Minutes taken by
11/09/2017 / 10:30 AM / 1:30 PM / Leanne Bailey
Meeting Purpose/Objective / Desired Outcome
Develop and maintain partnerships in order to facilitate networking, sharing of ideas, and pooling of resources. / Enhance awareness of and knowledge about immunizations among health care workers, caregivers and service providers.
Coalition Members Present
Please see Sign-In Sheet. Meeting attendance: 37
Discussion Topics
Anita Valiani with NC DPH opened the meeting with review of the 2016-17 Flu season. Flu went above baseline activity at the end of Dec 2016. A(H3) was the predominant strain until mid-March. Flu B was mainly reported from March-May. NCDPH now has more Influenza Like Illness (ILI) providers thanks to NCIC! The 2016-17 flu season had the most deaths (219) ever by one. Seven of these deaths were pediatric. Vaccination status is only known for 146 deaths, 43% were unvaccinated. Current flu season is at sporadic activity. Please encourage everyone to get vaccinated against the flu!!
Visit the following CDC FAQ webpage to learn more about this flu season:

Carolyn Herzig, CDC EIS Officer with NC DPH provided an overview of her research into Influenza-associated death reporting in NC. She evaluated the influenza-associated death surveillance system and worked to determine whether cases are over or under reported. She used both hospital discharge data and vital records. Strengths noted were: consistent marker of flu severity and timely information for communication and messaging. Areas for improvement: interpretation of case definition; ease of obtaining vaccination status; and outside of hospitals with public health epidemiologists, provider awareness is low. The next steps include: further exploration of differences in identified flu deaths across data sources; and to use available data to estimate the number of flu deaths per year in NC.
Stacey Gorski, Medical Science Liaison with Sanofi Pasteur provided a review of clinical data for Fluzone High-Dose (HD) Influenza Vaccine. Adults 65+ of age suffer disproportionately from influenza-related morbidity and mortality. They are 15% of the population but have 60% of hospitalizations and 90% of deaths. Key risk factors for influenza-related complications are: age 65+; chronic medical conditions; and weakened immune system. Fluzone HD was licensed by FDA in December 2009. The FIM12 study comparing Fluzone HD vs FluzoneStandard Dose (SD) showed overall 24.2% reduction of lab-confirmed, symptomatic influenza in this vulnerable population. First and second season real world evidence supports the idea that HD influenza vaccine reduces hospitalization risk for institutionalized elderly compared to SD vaccine.
Sandy Allen with NC DPH provided an overview of the current flu campaign. The state received CDC funds for new ads: The Shot Dodgers. Ads were based on research with local and national focus group testing. Characters include: skeptic – do vaccines work?;scaredy cat - don’t like shots; invincible – I’m too healthy; and multi-tasker – I’m too busy. TV ads (15 second and 30 second PSAs), social media ads and banner ads (static and active) are available for partner websites too. Copies of ads will be distributed with meeting minutes. The Immunization Program is looking for people to connect with them and use these ads to help encourage flu vaccination uptake.
Trish Vandersea with NC Hospital Association (NCHA) reviewed the Knockout Pneumonia Project. #pneumoniaknockout
In March 2017, The NCHA Board of Trustees approved a two-year Quality Goal to reduce pneumonia (PNE) mortality and readmission rates to put NC at and below the national average. Reducing PNE mortality by 7.5% would impact 1000 NC lives. Reducing PNE readmissions by 5.4% would prevent 950 readmissions and save $8,835,000. In annual CMS measures, NC ranked 49th in pneumonia mortality. PNE is among the top 10 causes of death in NC. They have looked at flu vaccination rates by county and PNE mortality by county as well as PNE patient characteristics. A PNE advisory group has been formed and recommended a cross continuum strategy. 74% of NC hospitals pledged to work to improve this measure. The hospital CEOs signed a formal pledge and agreed to submit a root cause analysis and identify opportunities for improvement. They have met with top two healthcare systems: Wake Forest Baptist and Carolinas Healthcare. World Pneumonia Day is Nov 12th. They are targeting efforts in 9 NC counties with the lowest immunization rates starting the end of November and continuing through 2018. They are hosting PNE immunization clinics in targeted areas. The NC Medical Society recently shared their materials. A data mining webinar series is also planned on use of QIO quality reports.
Visit the website for more details:
Elizabeth Hudgins with NC AAP provided a legislative update. Insurance is an important part of immunizations. As more adults are insured they become better at using it. FEDERAL: Children’s Health Insurance Program (CHIP) insures 49 million in NC. NC expected to run out of money for CHIP in Spring 2018. The House bill is named “Champion Act” – extends CHIP for 5 years and cuts PPHF. The Senate bill is called KIDS and extends for 5 years. Something should pass next week. Budget reconciliation Act should pass at end of year. STATE: Medicaid reimbursement for vaccines was frozen in 2012. NC submitted a State Plan Amendment (SPA) and it was approved at WAP cost + 3%. The details are still being worked on. Medicaid Reform in NC – NC is moving to managed care. Implementation plan is being worked on. Approximately 50% of population in NC covered by Medicaid. ACA marketplace is open now. It will only be open for 6 weeks this year. Share this info!
Meeting attendees networked and participated in a Materials Trade Show.
Note 2018 meeting changes! All meetings will be held on Wednesdays and will run from 9:30 AM – 12:30 PM at the same location (WakeMed Cary Hospital Conference Center, 1900 Kildaire Farm Rd, Cary, NC 27518).
Future meeting dates:
  • February 28, 2018
  • May 2, 2018
  • August 1, 2018
  • November 14, 2018

Please send Sandy Allen any suggestions for topics for future meetings.
Meeting adjourned.