CDC Updates Guidance for COVID-19 and Chickenpox Vaccines

The Centers for Disease Control and Prevention (CDC) recently updated its guidance for the COVID-19 and varicella (chickenpox) vaccines. The CDC’s decision uses an individual-based decision-making framework, referring to vaccination decisions made through shared clinical decision-making. The framework notes that vaccination should be determined based on patient characteristics, which can make broad-based recommendations difficult to apply.

The U.S. Food and Drug Administration approved marketing authorization for the COVID-19 vaccine to include those 65 and older and people at high risk for developing severe illness from the virus. This is in contradiction to policy in the past years, which recommended the vaccine for everyone six months and older.

The CDC also recommends updating the immunization schedule for chickenpox to be a standalone immunization rather than given in combination with the measles, mumps and rubella vaccines. This guidance is informed by evidence provided by the CDC Immunization Safety Office that states “Healthy 12–23 months old toddlers have an increased risk of febrile seizures seven to ten days after vaccination for the combined measles, mumps, rubella and varicella vaccine compared to those given immunization for chickenpox separately.”

The CDC stated that this change in decision making will continue to cover immunizations through payment systems that include Medicare, Medicaid, Children’s Health Insurance Program, the Vaccines for Children Program and private insurance plans.

Members with questions regarding this webinar or vaccine policy should contact the MHA Policy team.

CDC Urges Hospitals to Complete mPINC Survey

The 2024 Centers for Disease Control and Prevention (CDC) national survey of Maternity Practices in Infant Nutrition and Care (mPINC) will close June 10.

The CDC seeks to assess maternity care practices that influence how infants are fed, while providing feedback that advances hospitals’ ability to support breastfeeding families.

The mPINC survey contains six core sections and an additional section for hospitals with a Special Care Nursery or Neonatal Intensive Care Unit. The six core sections cover:

  • Hospital demographics and data
  • Early postpartum care practices
  • Feeding practices
  • Education and support of mothers and caregivers
  • Staff and provider responsibilities and training
  • Hospital policies and procedures

Survey administration begins after Battelle, the CDC’s contractor, completes a screening process. Battelle will screen all hospitals via phone by contacting the hospital’s maternity department unit managers. After determining eligibility, the manager is asked to identify the best person to complete a survey that includes questions about unit-level infant nutrition practices.

Nurses, doctors and hospital administrators can use mPINC data to highlight the strengths of their care practices and explain areas of process improvement. The CDC will provide individualized reports to participating hospitals identifying areas of practice improvements that have been shown to improve breastfeeding outcomes.

The mPINC data can be used beyond the hospital-level setting. However, all responses are treated in a secure manner and are not disclosed unless required by law. Additionally, state health departments, policymakers and other community partners may access this data to drive evidence-based improvements in maternity care practices and policies at hospitals in their state. The external use of data will be released under data use agreements for additional approved purposes. These data use agreements will require adherence to data confidentiality.

MHA members that provide maternity care services are encouraged to participate by the June 10 deadline.

Members can learn more by email or visiting the CDC’s mPINC webpage. Members with questions should contact Carlie Austin at the MHA.

MHA CEO Report — Vaccinations & Respiratory Illness Season

MHA Rounds image of Brian Peters

“An ounce of practice is worth more than tons of preaching.” Mahatma Gandhi

The last four years have generated tremendous awareness about vaccines, but also a large public health challenge as disinformation has exploded and anti-vaccine sentiment has emerged from the fringes to become widely embraced. This likely isn’t news to any of you, but the issue is once again top of mind because this time of year is respiratory illness season, whether it be the flu, RSV and now COVID. Thankfully, we have vaccines available to blunt the severe impacts of these illnesses, but it falls on both healthcare providers and public health professionals to appropriately communicate the benefits of vaccines to our patients and the public.

The recent reports from the Centers for Disease Control and Prevention (CDC) are concerning, as they are warning providers about the low vaccination rates for each of these diseases. Flu vaccination rates are down across all age groups compared to last year, while COVID vaccine uptake is the same as last year at just 17% of adults; similarly, only 17% of adults 60 years of age and older have received an RSV vaccine.

Due to these low vaccine rates, the CDC reported Dec. 14 that over the past four weeks, hospitalizations across the country increased 200% for the flu, 51% for COVID and 60% for RSV. In Michigan, we need look no further than last year to see how a surge of RSV illness can dramatically challenge the statewide capacity of our children’s hospitals. We know more can be done and it isn’t too late for people to receive their vaccines that are proven to reduce the risk of severe illness and hospitalization.

The MHA has a long history of support for vaccinations, as we continue to work with the Alliance for Immunizations in Michigan, the Parent Information Network, I Vaccinate and others to measure, educate and promote appropriate vaccinations for all Michigan residents. I Vaccinate specifically has been a terrific statewide public awareness campaign to connect with parents on the value of making sure you keep your children up to date on their vaccinations as they grow up. The bottom line is that the safety and efficacy of numerous vaccines has been supported and documented by not only the CDC, but the World Health Organization, and many other academic and clinical organizations.

We also know healthcare personnel play a key role in limiting the spread of illness during these months. For some time, we have collaborated with the Michigan Department of Health and Human Services to encourage vaccination policies for healthcare personnel against preventable diseases, such as the flu and pertussis.

Healthcare personnel are also important messengers when it comes to vaccines. We highly encourage all patients with questions about vaccines to contact their healthcare provider. These are important decisions and healthcare providers are uniquely qualified to provide accurate information about the benefits and any potential risks associated with any treatment. They also do so with care and respect for their patients. The MHA provides additional vaccine resources to healthcare leaders on our MHA vaccinations webpage.

Since the pandemic, the MHA has engaged in numerous ways on healthcare supply chain issues. On that note, another key challenge has been the available supply of Beyfortus, the monoclonal antibody for infants to prevent severe RSV illness. The MHA has been actively collaborating with stakeholders to navigate these supply concerns, as well as to provide reimbursement clarity. The good news is we have plenty of patients wishing to have their infants immunized, but due to manufacturing and distribution issues, there simply is not enough supply for all these young children. Thankfully the Biden administration recently announced 230,000 additional doses of RSV immunizations for infants will be available this month.

Realistically, we know we won’t change declining vaccination trends overnight, in a society that is as polarized as ever. Yet, I’m hopeful that over time we will be able to turn the tides, much as healthcare providers have for over a hundred years in using this valuable tool to eradicate harmful illnesses. It all starts with individual conversations from trusted messengers, but at the end of the day, we need to practice what we preach.

As always, I welcome your thoughts.