Vaccines for Adults Webinar: Adult Immunization Update 2022 - Immunization Branch California Department of Public Health March 2, 2022
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Vaccines for Adults Webinar:
Adult Immunization Update 2022
Immunization Branch
California Department of Public Health
March 2, 2022
Webinar Tech Tips!
1. Listen to today’s webinar through 2. If you cannot connect through
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2
Housekeeping
Attendee lines are automatically muted.
Please access today's slides at https://eziz.org/vfa-
317/vfa-resources/. The webinar is being recorded and
will be posted there after the event.
For webinar troubleshooting, please email Cecilia LaVu
at Cecilia.LaVu@cdph.ca.gov.
3
During the webinar, please use the Q&A panel to
comment or ask a question:
Q&A Panel
• Open the Q&A panel
• Select Ask: All Panelists
• Enter Text, Click Send
4
Agenda
• Program Updates-
Nisha Gandhi, Adult Immunization Coordinator
• ACIP Recommendations for Adult Immunizations-
Dr. Caterina Liu, CDPH Public Health Officer
• Q&A Session
5
VFA Program Updates
• Next ordering period: April 4-18, 2022
– New pneumococcal conjugate vaccine will be available for
ordering: PCV20 (Prevnar 20™, Pfizer)
– Stay tuned for specific programmatic implementation details
related to PCV13 and PPSV23 availability after Q2
• Next VFA webinar — Summer 2022 (TBD)
• Immunization Information System (IIS) Data Reports —
Summer 2022 (TBD)
6
Family Planning, Access, Care and Treatment
(Family PACT) and HPV Vaccine
• 2022-23 Governor’s Budget includes $8 million ($4.6 million
General Fund) to add HPV vaccine as a covered benefit for
Family PACT patients aged 19 – 45 years, effective July 1, 2022.
• Once in effect, please utilize this benefit for VFA-eligible,
Family PACT patients where HPV vaccination is recommended.
• Please contact the Family PACT program
(FamilyPact@dhcs.ca.gov or 916-650-0414) with questions.
7
ACIP RECOMMENDATIONS
FOR ADULT
IMMUNIZATIONS
CATERINA LIU, MD, MPH
8
Catch Up Your Adult Patients!
California
Immunization
Registry (CAIR)
2021 doses
still indicate a
need to catch
up on missed
doses in 2020.
Standards for Adult Immunization Practice
ADMINISTER or
ASSESS RECOMMEND REFER DOCUMENT
immunization vaccines that your patients to vaccines
status of all patients need. a vaccination received by
your patients at provider. your patients.
every clinical
encounter.
Standards for Adult Immunization Practice
10Assess Based on Age
Everyone 26 years 50 years 65 years
• Flu and and older and older
• Tdap/Td younger • Zoster • PCV20
• Hep B • HPV OR
• PCV15
and
PPSV23
See ACIP Table 1. for full age-based recommendations 12Assess for Indications
Chronic Disease Immunocompromised
• Diabetes • HIV
• Heart disease • Non-HIV
• Lung disease Immunosuppression
• Alcohol use disorder • Asplenia
• Chronic liver disease
• ESRD on hemodialysis
Occupational Behavior or Social Pregnancy
• Health care workers Conditions
• Special workplace • MSM
exposures • Drug use
• Homelessness
See ACIP Table 2. for all indications 14Overview: ACIP Adult Schedule Updates
• Pneumococcal vaccine recommendations simplified & updated:
– Population: All adults 65+ AND adults 19-64 with risk factors
– Updated regimen options: PCV20 OR PCV15 + PPSV23
• Hepatitis B vaccine recommended for all adults 19-59
• Zoster vaccine recommended for immunocompromised adults
19+
15Who should get pneumococcal vaccine?
• Everyone 65+
• People 19-64 with certain medical conditions
Immune CSF leak Cochlear HIV Cancer Liver disease
compromise implant
Alcohol use Cigarette Heart disease Lung disease Kidney disease
disorder Diabetes
smoking
16Updated Pneumococcal Vaccine Regimens
• New vaccine products: PCV15 and PCV20 licensed in 2021
for adults aged 18 years and older
• New regimen options recommended by ACIP:
– PCV20 only
– PCV15 + PPSV23
MMWR 2022;71:109–117
17How do the pneumococcal vaccines differ? ACIP 10/2021 Meeting Slides
Pneumococcal Vaccination for People 65+
• Never received PCV13 or previous vaccination history unknown:
• Previously received PPSV23 only (at least one year ago):
• Previously received PCV13 only (at least one year ago):
MMWR 2022;71:109–117
19Pneumococcal Vaccination for People 19-64 with
Risk Factors
• Never received PCV13 or previous vaccination history unknown:
*
*Minimum 8-week interval between doses if immunocompromised, cochlear implant, or CSF leak
• Previously received PPSV23 only (at least 1 year ago):
• Previously received PCV13 only (at least 1 year ago):
MMWR 2022;71:109–117
20Polling Question
1. Does your practice currently
offer PCV20 to your insured patients
(private stock)?
A. Yes
B. No
C. Not sure
21ACIP Recommendations Update:
Hep B Vaccine
• Hep B vaccine is now universally recommended for all adults aged 19 through
59 years.
• For people 60+, Hep B vaccine is recommended for people at increased risk.
Liver disease HIV Injection drug use Risk for exposure Sexual exposure Incarcerated
to blood risk
• Anyone aged 60+ years who does not meet risk-based recommendations may
still receive Hepatitis B vaccination.ACIP Recommendations Update: Zoster Vaccine Immunodeficient or immunosuppressed adults 19 years of age and older are recommended to receive 2 doses of recombinant zoster vaccine (Shingrix). Link to MMWR 2022;71:80–84
CLINICAL SCENARIOS
2022 Adult Immunization Schedule
24Debra is a 63-year-
old woman with
chronic liver
disease.
Which vaccines do
Scenario 1 you recommend?
25Scenario 1
Debra is a 63-year-old woman Vaccine Indication
with chronic liver disease.
Flu All ages
Which vaccines do you
recommend? Tdap/Td All ages (every 10y booster)
Zoster (RZV) ≥50 years
MMR 19-64 years If indicated
PCV15 and Chronic liver disease
PPSV23 OR PCV20
Hep A Chronic liver disease
Hep B ≥60 years w/ chronic liver disease
Offer COVID-19 vaccine and booster now
28Danielle is a 40-
year-old woman
about to start
chemotherapy for
breast cancer.
Which vaccines do
you recommend?
Scenario 2Scenario 2
Danielle is a 40-year-old Vaccine Indication
woman about to
start chemotherapy for breast Flu All ages
cancer. Which vaccines do you Tdap/Td All ages (every 10y booster)
recommend?
Zoster (RZV) Immunocompromised ≥19 years
PCV15 and Immunocompromised ≥19 years
PPSV23 OR
PCV20
Hep B All adults aged 19-59 years
Offer COVID-19 vaccine and booster now
32Manuel is a 60-
year-old
man with chronic
renal failure.
He received PPSV23
vaccine 2 years ago.
Which vaccines do
Scenario 3 you recommend?Scenario 3
Manuel is a 60-year-old man Vaccine Indication
with chronic renal failure. He Flu All ages
received PPSV23 vaccine 2 years
ago. Which vaccines do Tdap/Td All ages (every 10y booster)
you recommend? MMR All adults 19-64 years If
indicated
Zoster (RZV) All adults ≥50
PCV15 or PCV20 Chronic renal failure
Hepatitis B Adults 60 with risk factors
Offer COVID-19 vaccine and booster
36ACIP Schedule 2022
• Added appendix listing the contraindications and precautions
for commonly used vaccines:
ACIP Adult Immunization Schedule 2022
37Resources to Help You Assess
ACIP Adult AAFP and STFM CDC Patient
Immunization CDC vaccine
Schedule table schedules app vaccine Vaccine
schedules app QuestionnaireCOVID-19 VACCINE UPDATES
39ACIP Recommendations: COVID-19 Vaccine
• Primary series recommended for everyone ages 5 and older
• Boosters recommended for people 12 years and older
• Can be administered on the same day as other vaccines
• Currently available vaccines: Pfizer (Comirnaty), Moderna
(SpikeVax), Johnson & Johnson
Resources
COVID-19 ACIP Vaccine Recommendations
Interim Clinical Considerations for Use of COVID-19 VaccinesResource Link 41
Enroll in the COVID-19 Vaccine Program Today!
Key reasons to enroll in the COVID-19 Vaccine Program:
• Helps increase access to vaccines!
• VFA/VFC Providers are already set up for proper storage and administration! Read more!
• Ultra-low freezers not required
• Providers can order vaccine in smaller quantities.
• Providers CAN RECEIVE reimbursement for educating about or administering COVID-19 vaccine.
• Providers CAN GET staffing support to administer COVID-19 vaccine.
• There are many ways to get enrollment support to help you through the process, including
incentives up to $10K for enrolling in the program!
Your strong recommendation is one of the most important factors in your patients’
decision to get vaccinated! 42Additional Support
Type of Support Description Updated 12.29.21
The COVID-19 Call Center for Providers and Local Health Departments is dedicated to medical providers in California and
COVID-19 Provider their COVID-19 response, specifically addressing questions about State program requirements, enrollment, and vaccine
Call Center distribution, including the Vaccine Marketplace.
• Email: covidcallcenter@cdph.ca.gov
• Phone: (833) 502-1245, Monday through Friday from 8AM–6PM
Enrollment Support For Provider enrollment support, please contact myCAvax Clinic Operations at
• Email: myCAvaxinfo@cdph.ca.gov
Dedicated staff provide up-to-date information and technical support on the myCAvax system.
myCAvax Help Desk • Email: myCAvax.HD@Accenture.com
• Phone: (833)-502-1245, option 3, Monday through Friday 7AM–7PM, Saturday and Sunday 8AM-1PM
For training opportunities: https://eziz.org/covid/education/
For onboarding support (those in the process of onboarding): myturnonboarding@cdph.ca.gov
My Turn Clinic Help Desk
For technical support with My Turn Clinic for COVID-19 and flu vaccines: MyTurn.Clinic.HD@Accenture.com or
(833) 502-1245, option 4: Monday through Friday 7AM–7PM, Saturday and Sunday 8AM–1PM.
For job aids, demos, and training opportunities: flu at https://eziz.org/covid/myturn/flu/ and COVID at https://eziz.org/covid/myturn/
Archived For archived communications from the COVID-19 Provider Call Center about the California COVID-19 Vaccination Program
Communications visit
• Website: EZIZ Archived Communications
43Upcoming Office Hours for Enrolled Providers:
• Provider Office Hours: Fridays, 9AM-10AM
◦ Register here
◦ Session password: Immunize!
My Turn / myCAvax Office Hours: Mondays, 12PM-1PM
o Register here
o Session Password: Immunize!
44COVID-19 Vaccine: Patient Resources
Resource Link
More Resources
• COVID-19 vaccine patient
resources (EZIZ)
• Vaccine Recipient Education: Resource Link
Quick References (CDC) Resource Link
• Resources for Workers (CDPH) Other Languages
• Vaccinate All 58 Toolkit
45COVID-19 Vaccine: Provider Resources
46COVID-19 Vaccine: Provider Resources
Crucial COVID-19 Conversations Campaign
• Series of provider trainings to equip with
tools and techniques to proactively talk
with patients about the merits of the
COVID-19 vaccine and help them make a
vaccine appointment.
• Visit
https://eziz.org/covid/30conversations/
for slides and recordings of all trainings.
47Additional Resources
• 2022 Adult Immunization Schedule
• ACIP General Best Practices Updates
• ACIP Schedule Changes and Guidance
UPDATED VERSION
• Pneumococcal Vaccine Timing Tool for Adults NOW POSTED!
• CDC Clinical Considerations for mRNA COVID-19 Vaccines
• COVID-19 Vaccination Clinical & Professional Resources (CDC)
• Myths and Facts about COVID-19 Vaccine
48EW!
VFA Resources
N
bit.do/VFAresources
UPDATED!
Infographic
UPDATED!
317 Eligibility Screening
2022 Program Participation Record for Adult Patients
Requirements at a Glance 49Polling Question
2. If your clinic ordered more Shingrix doses in Jan
2022 than in previous ordering periods, please select
the best reason why.
A. Seeing more patients without Medicare Part D
B. Seeing more uninsured patients
C. Ordering more to meet expanded age recommendations
D. Generating more patient demand through clinic efforts
(e.g., reminder/recall)
E. Ordering VFA doses of Shingrix for the first time
F. N/A (Did not order more VFA doses of Shingrix in
January)
G. Another reason
3. If your response to Question 2 above is "G" (another
reason), please explain why in the comments box of
Question 3.
50Q&A SESSION
51my317vaccines@cdph.ca.gov Please fill out a short VFA webinar evaluation! https://www.surveymonkey.com/r/VFAwebinarsurvey
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