Practical Approaches to Overcoming Vaccine...

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Practical Approaches to Overcoming Vaccine Hesitancy

Brought to you as a public health service by Sanofi Pasteur Inc.

MKT26560 7/13

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What Is Vaccine Hesitancy?

• Intent to skip or delay at least 1 of the vaccines recommended by the

Advisory Committee on Immunization Practices (ACIP)1,2

• Uncertainty as to whether a vaccine should be administered in

accordance with the ACIP recommended immunization schedule1,2

– In spite of that uncertainty, some vaccine-hesitant parents will allow their

children to be immunized anyway2

Such parents are at risk for skipping or delaying other vaccines down the road3

• Steps that health care professionals (HCPs) can take to minimize the

impact of vaccine hesitancy4:

– Establish trusting relationships with parents/patients

– Provide appropriate educational materials

References: 1. Heller G, Roberts M. Turning the tide: addressing vaccine hesitancy and timely immunizations through a

social marketing campaign. Presented at: 44th National Immunization Conference, Atlanta, Georgia, April 21, 2010.

Abstract 22697. 2. Opel DJ, et al. Hum Vaccines. 2011;7(4):419-425. 3. Dempsey AF, et al. Pediatrics. 2011;128(5):848-

856. 4. Gust DA, et al. Pediatrics. 2008;122(4):718-725.

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Vaccine Hesitancy: Not a New Problem

• Turn of the 19th century: Vaccination is introduced in the

United States (US)1

• 1809: Massachusetts is the first state to make smallpox

vaccination compulsory1,2

• 1850s: US anti-vaccination movement arises in response to

the proliferation of smallpox vaccination mandates1,2

– Activists object to regulations requiring submission to a procedure

that involves discomfort and that might not be safe 2

• 1870s: Smallpox re-emerges in the US, as a result of a

decline in vaccination rates1

– Opposition to vaccination increases as new laws are passed and old

ones to control smallpox are reinforced1

References: 1. Omer SB, et al. N Engl J Med. 2009;360(19):1981-1988. 2. Colgrove J. State of Immunity: The Politics

of Vaccination in Twentieth-Century America. Berkeley, CA: University of California Press; 2006.

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Impact of Non-medical Exemptions on Vaccination Rates

• Overall mean state-level rates of non-medical exemptions

have increased; pace of that increase has accelerated1-3

• Vaccination coverage rates are lower in states with personal

belief exemptions (PBEs) than in states permitting only

religious exemptions1,3

• Children with non-medical exemptions tend to aggregate

within schools and communities2,4

• Vaccine-preventable diseases tend to cluster in areas

where exemption rates are highest5-7

References: 1. Omer SB, et al. N Engl J Med. 2012;367(12):1170-1171. 2. Omer SB, et al. N Engl J Med.

2009;360(19):1981-1988. 3. Omer SB, et al. JAMA. 2006;296(14):1757-1763. 4. Buttenheim A, et al. Am J Public

Health. 2012;102(8):e59-e67. 5. Feikin DR, et al. JAMA. 2000;284(24):3145-3150. 6. Centers for Disease Control

and Prevention (CDC). MMWR. 2008;57(8):203-206. 7. Omer SB, et al. Am J Epidemiol. 2008;168(12):1389-1396.

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High Incidence of Pertussis in States That Allow PBEs: US, 2012a

a States shown in purple allow religious exemptions but not PBEs, whereas states shown in green allow both religious exemptions and PBEs. In Missouri, PBEs are permitted only for children in day care, preschool, and nursery school.2,3 Map adapted from Harrington JW.3

References: 1. CDC. Data on file (2012 Provisional Pertussis Surveillance Report), March 2013. MKT26422. 2. National Conference of State Legislatures. States with religious and philosophical exemptions from school immunization requirements. http://bit.ly/14m1gjt. Accessed June 7, 2013. 3. Harrington JW. Consultant Ped. 2011;10(11):S17-S21.

White check marks indicate states where the documented incidence of pertussis exceeded the national average during 2012.1

Allow religious exemptions but not PBEs

Allow medical exemptions only

Allow religious exemptions and PBEs

In 12 of 19 (63%) states

permitting PBEs and

9 of 31 (29%) states not

allowing PBEs, the

documented incidence of

pertussis was higher than

average.2

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High Incidence of Measles in States That Allow PBEs: US, 2011

a Import-associated describes cases brought into the US from other countries; cases linked epidemiologically to importations of measles into the US; cases with virologic evidence suggesting recent importation; and cases linked to patients with virologic evidence of recent importation. Map reproduced from CDC.1

References: 1. CDC. MMWR. 2012;61(15):253-257. 2. National Conference of State Legislatures. States with religious and philosophical exemptions from school immunization requirements. http://bit.ly/14m1gjt. Accessed June 7, 2013.

Red check marks indicate states that allow PBEs and had a high incidence of measles during 2011.1,2

Import-associateda

Unknown source

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Factors That Contribute to Vaccine Hesitancy

• Increase in:

– Number of new vaccines for various diseases

– State-level school entry immunization mandates

• Continued success of vaccines in controlling diseases that parents/patients

no longer remember and rarely see1

• Rise in consumerism, which has2:

– Encouraged parents/patients to shop around for an HCP and actively search

for information about vaccines

– Eroded parents’/patients’ trust in HCPs

• Spread of misinformation via mass media and the internet3

• Growing willingness to question the integrity of scientists, public health officials,

and anyone else involved in formulating immunization policies4

References: 1. Harrington JW. Consultant Ped. 2011;10(11):S17-S21. 2. Timmermans S, Oh H. J Health Soc Behav.

2010;51(suppl):S94-S106. 3. Opel DJ, et al. Arch Pediatr Adolesc Med. 2009;163(5):432-437. 4. Colgrove J. State of

Immunity: The Politics of Vaccination in Twentieth-Century America. Berkeley, CA: University of California Press; 2006.

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Vaccine-Hesitant Parents Are Not All the Same1

• In a study by Gust and colleagues, 28% of parents

had doubts about vaccination

• Concern about vaccine safety was a predictor of

vaccine delay or refusal

• Parents with doubts about immunizations differ in

their reasons for those doubts

Reference: 1. Gust DA, et al. Pediatrics. 2008;122(4):718-725.

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Types of Vaccine-Hesitant Parents1,2

• Uninformed but educable

– Want education to counter anti-vaccine information

• Misinformed but correctable

– Need information about vaccine benefits

• Well-read and open-minded

– Want to intelligently discuss pros and cons

• Strongly vaccine-hesitant

– Willing to listen but not likely to change their mind right away

• Strong-willed and committed against vaccines

– Want to sway the HCP to their line of thinking

References: 1. Harrington JW. Consultant Ped. 2011;10(11):S17-S21. 2. Halperin SA. Canadian J CME. 2000;12(1):

62-74.

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The ASK Approach for Effective Immunization Communication1

• Acknowledge the parent’s/patient’s concerns

– Ask for clarification to understand their needs; sometimes a simple

fact is all that’s needed to dispel a myth or misunderstanding

• Steer the conversation

– Refute the myth or misunderstanding with facts

– If the parent/patient is not already committed against vaccines,

continue your conversation to identify additional obstacles

• Know your facts; be confident and prepared

– Recommend or provide reading material

– Refer the parent/patient to reliable internet resources

– Make your professional recommendation crystal clear

Reference: 1. Morgana T, Pringle J. Approaches to families questioning vaccines—the ASK approach for effective

immunization communication. Presented at: 48th Annual Meeting of the Infectious Diseases Society of America, Vancouver,

BC, October 23, 2010. Abstract 92.

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The CASE Framework for Conversations about Vaccines1

• Corroborate

– Acknowledge the parent’s/patient’s concern

– Find some point on which you and the parent/patient can agree

– Set the tone for a respectful conversation

• About me

– Talk about what you’ve done to enhance your knowledge and expertise (eg, attended a conference)

• Science

– Describe what science has to say about the topic in question

• Explain and advise

– Offer your recommendation, based on the science

Reference: 1. Singer A. Making the CASE for vaccine communication: a new model for talking to parents about

vaccines. November 2011. http://bit.ly/14lKlh4. Accessed June 7, 2013.

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Tips for Handling Vaccine Hesitancy

• Take a (or another) deep breath – Listen to the parents/patients

– Identify their questions or problems

– Make no assumptions

• Have a plan – What is your practice philosophy?

– Will you see families who outright refuse all vaccines for

their children?

• Tailor your advice to each individual

parent/patient, based on his or her concerns

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Tips for Handling Vaccine Hesitancy (cont)

• Document your discussion with the parent/patient

• Revisit the discussion at each subsequent visit

– Inform the parent/patient that you will be doing so

• For parents/patients who refuse, provide the Vaccine Information

Statement and consider using a Refusal to Vaccinate form

• For unimmunized or partially immunized patients, flag the chart for the

benefit of yourself and other HCPs, in the event that those patients

require sick visits

• Be direct, clear, and authoritative with respect to your office’s philosophy

and policy vis-à-vis a parent’s/patient’s ongoing refusal to vaccinate

– Know the plan, and maintain a consistent approach within your practice

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Concerns That Have Been Raised Regarding Vaccines

• “Overloading of the immune system”1,2

• “Autism or other neurologic side effects”1

• “Mercury exposure and brain damage”1,3

• “Aluminum toxicity and brain damage”1,3

• “Formaldehyde injection”3

References: 1. Harrington JW. Consultant Ped. 2011;10(11):S17-S21. 2. Offit PA, et al. Pediatrics. 2002;109(1):124-

129. 3. Offit PA, Jew RK. Pediatrics. 2003;112(6):1394-1401.

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Key Facts About Multiple Vaccines and the Immune System

• An infant’s immune system has the capacity to respond to thousands of

antigens at any given time1

– Immune system is constantly replenished; it cannot be overloaded by the

antigens (ie, proteins and polysaccharides) in vaccines1

– In fact, children are exposed to thousands of antigens every day (on toys,

doorknobs, and playground equipment)2

• Although the number of recommended vaccines has increased over the

years, children today typically receive fewer antigens than their parents

did in the past1,2

• The response to multiple vaccines given during a single visit is similar

to the response that occurs when individual vaccines are administered

separately1

References: 1. Offit PA, et al. Pediatrics. 2002;109(1):124-129. 2. Harrington JW. Consultant Ped. 2011;10(11):S17-S21.

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Debunking of the “Link” Between Vaccines and Neurologic Side Effects

• In 2010, The Lancet retracted the 1998 report alleging a link between

vaccines and autism1

– Numerous studies have demonstrated that no such link exists

• Vaccines are given at around the same time that autism becomes

apparent; however, they do not cause autism2

– To explain the difference between causal and temporal relations, use the

analogy of the rooster that crows every morning

The sun will rise whether or not the rooster crows

• Signs of autism in a child may predate a vaccination but not be noticed

until after a particular vaccine has been given2

• The increased number of vaccines recommended for children has not

resulted in a higher prevalence of neurodevelopmental problems2-4

References: 1. Healy CM, Pickering LK. Pediatrics. 2011;127(suppl 1):S127-S133. 2. Harrington JW. Consultant Ped.

2011;10(11):S17-S21. 3. Institute of Medicine. The childhood immunization schedule and safety: stakeholder concerns,

scientific evidence, and future studies. Washington, DC: National Academies Press; 2013. 4. DeStefano F, et al. J

Pediatrics. 2013. Epub ahead of print.

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Safety of Thimerosal and Aluminum Salts in Vaccines

• Thimerosal: a mercury-containing preservative that helps prevent

bacterial or fungal contamination in vaccines1

– No scientific evidence that links thimerosal with autism2

– Symptoms of mercury poisoning differ from those of autism3

– Measles, mumps, and rubella vaccine never contained thimerosal or

any other form of mercury2

– As a precautionary measure, thimerosal was removed from nearly all

vaccines (the exception being multidose vials) in 20012

Yet the incidence of neurodevelopmental problems has continued to rise

• Aluminum salts: an adjuvant to enhance the immune response2

– Safety is well established1,2

– All infants are exposed to aluminum in the environment (eg, breast milk,

infant formulas)1

References: 1. Offit PA, Jew RK. Pediatrics. 2003;112(6):1394-1401. 2. Harrington JW. Consultant Ped.

2011;10(11):S17-S21. 3. Healy CM, Pickering LK. Pediatrics. 2011;127(suppl 1):S127-S133.

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Key Facts About Formaldehyde1

• Is used to inactivate:

– Viruses that cause influenza and polio

– Tetanus and diphtheria toxins

• Is diluted during the manufacturing process

• Is required for the synthesis of thymidine, purines,

and amino acids in all humans

– Quantity of formaldehyde found naturally in an infant’s

blood is 10-fold greater than that contained in any

individual vaccine

Reference: 1. Offit PA, Jew RK. Pediatrics. 2003;112(6):1394-1401.

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Common Reasons for Vaccine Refusal on Religious Grounds

• “God, not immunity, protects my child from illness”

• “The use of fetal cells in vaccine production is

immoral”

• “The use of vaccines containing pork gelatin is

wrong”

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“God, not Immunity, Protects my Child from Illness”

• Ask for clarification of that statement

– This will help you determine whether the parent’s refusal of

immunizations is indeed an act of faith

• If a parent states his or her religion specifically prohibits

vaccination, a religious exemption may be in ordera

– Such exemptions are often granted to members of the Christian

Science and Amish faiths1

– Note: Amish religious doctrine does not specifically prohibit

vaccination2

Common non-religious reasons for vaccine hesitancy among the Amish:

– Concerns about vaccine safety and infant’s ability to tolerate vaccines

– Idea that vaccination is not a priority

– Feeling that it’s too difficult to travel to places where vaccinations are offered

a Mississippi and West Virginia do not allow religious exemptions.

References: 1. Calandrillo SP. Univ Mich J Law Reform. 2004;37(2):353-440. 2. Wenger OK, et al. Pediatrics.

2011;128(1):79-85.

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“The Use of Fetal Cells in Vaccine Production is Immoral”

• Cell lines derived from aborted fetal lung tissue were used to develop vaccines

against diseases such as hepatitis A, polio, rubella, and varicella1,2

– Some Catholics may refuse vaccination in order to express their strong opposition to

abortion1

– Others may believe that vaccination involves some form of cooperation with abortion1

• Bear in mind that the lung tissue for those cell lines was from 2 fetuses that

were aborted during the 1960s2

– The cells used today are grown in culture1

• The Vatican supports use of all vaccines available at this time2

– Administration of those vaccines is morally justified because they:

Avoid a serious risk

Provide for the good of children and all who come in contact with them

– However, alternative vaccines should be used if and when they become available

References: 1. Furton EJ. Ethics & Medics. 1999;24(3):3-4. 2. Vatican Statement on Vaccines Derived from Aborted Human Fetuses. http://bit.ly/11xmRo6. Accessed June 7, 2013.

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“The Use of Vaccines Containing Pork Gelatin is Wrong”1

• Islam and Judaism accept vaccination

• According to Islamic legal scholars, it is permissible

for observant Muslims to receive vaccines

containing pork gelatin

• According to Orthodox Rabbi Abraham Adler,

Jewish laws do allow receipt of non-oral products

containing porcine ingredients

Reference: 1. Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health. Religious Leaders Approval of Use of Vaccines Containing Porcine Gelatin. http://www.vaccinesafety.edu/Porcine-vaccineapproval.htm. Accessed June 7, 2013.

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Common Philosophical Objections to Vaccination

• “Too much, too soon?”

• “Natural disease provides better immunity”

• “Most of the vaccine-preventable diseases don’t

even exist anymore”

• “My [fill in the blank] told me not to let you

vaccinate my baby”

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“Too Much, Too Soon?”1

• Offer reassurance

– Vaccines do not overload the immune system

– Every day an infant encounters thousands of antigens (parts of

germs that cause the immune system to fight disease)

• Explain why it’s best to follow the recommended

immunization schedule

– Goal: To ensure that the child is immune to diseases before he or

she is most likely to be exposed

– The vaccines have been tested at the recommended ages, so we

know they’re safe, even in young children

Reference: 1. CDC. The childhood immunization schedule. February 2013. Available at: http://1.usa.gov/19PrMnT.

Accessed June 7, 2013.

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“Natural Disease Provides Better Immunity”

• Explain that:

– The cost of natural immunity can be severe1

Fatal disease is not a risk worth taking

– Not vaccinating one’s child puts his or her entire community at risk

• If possible, cite cases of disease from your own

experience as an HCP

Reference: 1. Offit PA, Moser CA. Pediatrics. 2009;123(1):e164-e169.

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“Most of the Vaccine-preventable Diseases Don’t Even Exist Anymore”

• Explain that once-prevalent vaccine-preventable diseases

may return if high immunization rates are not maintained

• Give examples of recent outbreaks

– Invasive Haemophilus influenzae type b disease1: Minnesota in 2008

– Measles2: California, Pennsylvania, and Washington in 2011 (as

indicated on an earlier slide)

• If possible, cite cases of vaccine-preventable disease from

your own experience as an HCP

References: 1. CDC. MMWR. 2009;58(3):58-60. 2. CDC. MMWR. 2012;61(15):253-257.

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“My [Fill in the Blank] Told Me not to Let You Vaccinate my Baby”1,2

• Ask for clarification: What are the underlying

concerns of the person who gave that advice?

• Offer your recommendation, based on facts

• Recommend or provide reading material

• Refer the parent to reliable resources

References: 1. Morgana T, Pringle J. Approaches to families questioning vaccines—the ASK approach for effective

immunization communication. Presented at: 48th Annual Meeting of the Infectious Diseases Society of America, Vancouver,

BC, October 23, 2010. Abstract 92. 2. Singer A. Making the CASE for vaccine communication: a new model for talking to

parents about vaccines. November 2011. http://bit.ly/14lKlh4. Accessed June 7, 2013.

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Ways You Can Encourage Discussion With Vaccine-Hesitant Parents/Patients

• “Help me understand how you came to that

decision”

• “Help me understand your reasons for feeling

that way”

• “What is it about vaccines that worries you?”

• “Share with me what you’ve read”

• “Share with me what you’ve heard about getting

2 or more shots at once”

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Helpful CDC and AAP Resources for HCPs

• CDC resources for vaccine conversations with parents:

http://1.usa.gov/18TMMbH

• AAP webpage titled Communicating with Families:

http://bit.ly/14lNSM5

• AAP webpage titled Parental Refusal to Vaccinate:

http://bit.ly/11K7cNR

– Refusal to Vaccinate form

– AAP clinical report, titled “Responding to Parental Refusals of Immunization

of Children”1

– Coding resources for vaccine refusal

– Sample office vaccine policy statement (for distribution to parents)

– Sample office poster

– Resources to answer questions

Reference: 1. Diekema DS, Committee on Bioethics. Pediatrics. 2005;115(5):1428-1431.

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Helpful Resources for Parents

• Vaccine Education Center at The Children’s Hospital of Philadelphia: http://www.vaccine.chop.edu

• AAP’s Childhood Immunization Support Program: http://bit.ly/15FmyHW

• Sanofi Pasteur’s ImmYOUnitySM website:

http://vaccines.com/about-immyounity.cfm

• Vaccinate Your Baby: http://www.vaccinateyourbaby.org

• Offit PA, Bell LM. Vaccines: What Every Parent Should Know. New York, NY:

IDG Books; 1999

• Humiston SG, Good C. Vaccinating Your Child: Questions and Answers for the

Concerned Parent. Atlanta, GA: Peachtree Publishers; 2000

• Fisher MC. Immunizations & Infectious Diseases: An Informed Parent’s Guide.

Elk Grove Village, IL: AAP; 2005

• Myers MG, Pineda D. Do Vaccines Cause That? A Guide for Evaluating Vaccine

Safety Concerns. Galveston, TX: Immunizations for Public Health; 2008

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Additional Resources for HCPs and/or Parents

• Immunization Action Coalition: http://www.vaccineinformation.org

• Immunization Education Program of the AAP’s Pennsylvania chapter: http://www.paiep.org

• Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health: http://www.vaccinesafety.edu

• National Association of Pediatric Nurse Practitioners: http://bit.ly/13f06Du

• National Network for Immunization Information: http://www.immunizationinfo.org

• Pediatric Infectious Diseases Society position statement on PBEs: http://bit.ly/187OMjv

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Backup

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Evolution of Public Health Laws Concerning Vaccination

• 1905: Jacobson v Massachusetts establishes rights of states

to pass and enforce vaccination laws1

• 1910: First philosophical exemption law is passed2

• 1922: Supreme Court finds school immunization laws

constitutional1

• 1970s: Immunization laws are strengthened and strongly

enforced1

• 2013: School immunization laws vary among states3

– 50 states permit medical exemptions

– 48 states permit religious exemptions

– 19 states permit personal belief exemptions (PBEs)

References: 1. Omer SB, et al. N Engl J Med. 2009;360(19):1981-1988. 2. Dr. John Talarico, California Department

of Public Health, personal communication, October 5, 2011. 3. National Conference of State Legislatures. States with

religious and philosophical exemptions from school immunization requirements. http://bit.ly/14m1gjt. Accessed June 7,

2013.

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Number of Immunogenic Proteins and Polysaccharides Contained in Vaccines Over the Past 100 Years

1900 1960 1980 2000

Vaccine Proteins Vaccine Proteins Vaccine Proteins Vaccine Proteins/

Polysaccharides

Smallpox ~200 Smallpox ~200 Diphtheria 1 Diphtheria 1

TOTAL ~200 Diphtheria 1 Tetanus 1 Tetanus 1

Tetanus 1 WC pertussis ~3000 Acellular pertussis 2-5

WC pertussis ~3000 Polio 15 Polio 15

Polio 15 Measles 10 Measles 10

TOTAL ~3217 Mumps 9 Mumps 9

Rubella 5 Rubella 5

TOTAL ~3041 Hib 2

Varicella 69

Pneumococcus 8

Hepatitis B 1

TOTAL 123-126

More Childhood Vaccines— But Fewer Antigens

Thanks to advances in technology, vaccines today contain fewer antigens. Even with more vaccines, the total immunologic load is much less.1,2

References: 1. Offit PA, et al. Pediatrics. 2002;109(1):124-129. 2. CDC. Vaccines and How They Work. 4th ed. CDC, National Immunization Program, Immunization Services Division; 2004.

WC = Whole-cell.

Reproduced with permission from Pediatrics. 2002;109(1):124-129.

Copyright © 2002 by the American Academy of Pediatrics.

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Time-based CPT®a Billing Codes for Office Visits With Vaccine-Hesitant Parents

• When 50% or more of the visit is spent on counseling (as

opposed to patient history or physical examination):

– Use 99214 if the visit lasts at least 25 minutes and less than 40 minutes

– Use 99215 if the visit lasts at least 40 minutes

• Keep in mind that time-based billing codes can be used only

if the topics of counseling are well documented

• If a parent is already known to be vaccine-hesitant and is

scheduling an appointment, be sure to:

– Give that parent a 30-minute slot

– Advise the staff to use a time-based billing code for that visit

a CPT (Current Procedural Terminology) is a registered trademark of the American Medical Association.

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Providing Parents With Accurate Information

• Most parents seek out information about vaccine safety from

other people and from media outlets before taking their child to

be immunized1

– Parents are increasingly using the internet to obtain vaccine

information

• HCPs remain 1 of the most important sources of information and

advice for parents making immunization decisions and can help

build parental confidence in vaccines1-3

• Assisting HCPs in their efforts to communicate with parents

about vaccines should remain a priority for national, state, and

local immunization programs2

References: 1. Kennedy A, et al. Health Affairs. 2011;30(6):1151-1159. 2. Gust DA, et al. Pediatrics.

2008;122(4):718-725. 3. Freed GL, et al. Pediatrics. 2011;127(suppl 1):S107-S112.

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Vaccine Hesitancy and Suboptimal Immunization Rates Among Adults

• Coverage rates remain suboptimal for most vaccines that are routinely

recommended for adults1,2

• 2010 National Foundation for Infectious Diseases telephone survey of

1013 adults3:

– 21% believe immunizations are optional for healthy adults

– 27% report refusing a vaccine offered to them by their HCP

Primary reason for refusal is lack of concern about getting the disease

• Many parents—even those whose children are fully vaccinated—may

hesitate to be vaccinated themselves

– Some are skeptical of the need for those immunizations

– Others harbor doubts about the safety and efficacy of 1 or more

immunizations

References: 1. CDC. MMWR. 2013;62(4):66-71. 2. CDC. Flu vaccination coverage, United States, 2011-12

influenza season. http://1.usa.gov/12wMN6y. Accessed June 7, 2013. 3. National Foundation for Infectious

Diseases Survey: Disconnect in What Doctors Think They Say About Vaccines and What Patients Hear.

November 2010. http://bit.ly/11pe9Vu. Accessed June 7, 2013.

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Sanofi Pasteur’s ImmYOUnitySM Educational Campaign

• Helps answer questions about vaccines for family members of all ages

• Offers online and print material that HCPs can use to supplement discussions

about vaccination with patients and parents

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“Infographics”: A Simple Way to Understand and Share Key Facts

• Consumer-friendly, balanced, science-based information

• Website content that can be shared via social media and e-mail

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How ImmYOUnity Can Help

• Public health departments, health systems, clinics,

and others can link to www.vaccines.com from their

own websites

• ImmYOUnity brochures can be disseminated to

clinicians, patients, and parents

• Evolving campaign is open to input from HCPs and

families to further support efforts to educate and

immunize

– For more information, call 1-800-VACCINE (1-800-822-2463),

or contact a Sanofi Pasteur representative

Practical Approaches to Overcoming Vaccine...

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