Attention, AAFP members -- it's time to check your mailbox. The Academy is sending new immunization resources your way.
In late April, the Academy began mailing all active members laminated, full-color copies of the 2020 adult, childhood/adolescent and catch-up recommended immunization schedules that were developed by the CDC's Advisory Committee on Immunization Practices in conjunction with the AAFP and other medical specialty organizations.
Members also can access the immunization schedules for children, teens and adults on the AAFP mobile app or via the Shots Immunizations app developed by vaccine experts from the Academy and the Society of Teachers of Family Medicine.
Funding to print and mail the immunization schedules was provided by a grant from Merck & Co. Inc.
The annual immunization materials aim to serve a number of purposes. They not only provide FPs with the latest vaccine-related information and joint recommendations from the ACIP, AAFP and other medical organizations, but also serve as a valuable communication tool for FPs to share information about the importance of immunizations with their patients.
- The AAFP recently mailed all active members full-color copies of the 2020 immunization schedules developed by the Advisory Committee on Immunization Practices with help from the Academy and other medical specialty groups.
- Copies of the schedules also are available on the AAFP mobile app and the Shots Immunizations app.
- Family physicians can use these materials to share information about the importance of immunizations with their patients.
Pamela Rockwell, D.O., of Ann Arbor, Mich., the AAFP's liaison to the ACIP, detailed important updates to the schedules in an email to AAFP News.
"The adult and child/adolescent immunization schedules have been streamlined and revised in content, color graphics and notes to harmonize the two schedules," Rockwell said. "Both schedules list notes with clearer language and larger fonts than used for footnotes in previous years."
Rockwell pointed out several updates to the new schedules, some of which have been previously discussed:
- The hepatitis A vaccine is now recommended as a catch-up vaccine for all children and adolescents up to age 18 if they were not previously vaccinated with a two-dose series. Minor changes to the notes involve special populations for whom the vaccine is recommended.
- HPV vaccine is now recommended for men and women through age 26, with shared clinical decision-making for patients 27 through 45 years.
- Measles, mumps and rubella vaccine recommendations for health care personnel have been clarified. Health care personnel born in 1957 or later with no evidence of immunity should receive a two-dose series of MMR vaccine, while for those born before 1957 with no evidence of immunity, a two-dose vaccine series should be considered.
- Either tetanus toxoid or tetanus, diphtheria and pertussis vaccine may now be used as an option for decennial tetanus booster doses and catch-up series doses in people who have previously received Tdap. Additional guidance is given for children and adolescents ages 7-18 years who received Tdap vaccine or diphtheria, tetanus toxoids and acellular pertussis vaccine at age 7-10.
- Pneumococcal conjugate vaccine is no longer routinely recommended for immunocompetent adults 65 and older but may be administered with shared clinical decision-making. PCV13 is still recommended for those older adults with additional risk factors. Polysaccharide vaccine is still recommended for all adults 65 and older.
- A booster dose of meningitis B vaccine one year after the primary series and revaccinations every two to three years if the risk for meningitis B infection remains (i.e., for those with asplenia or who work with meningitis B in a laboratory setting) is now recommended.
Immunizations in the Time of COVID-19
Given the extensive research(arstechnica.com) being conducted on a potential vaccine for SARS-CoV-2, the virus strain that causes COVID-19, Rockwell said that family physicians should expect patients to ask when a coronavirus vaccine will be available. Although the possibility exists that a vaccine may be ready(www.npr.org) in early 2021, Rockwell recommended that FPs and patients continue to take steps to reduce the risk of infection.(2 page PDF)
"This vaccine may take longer to become available to the general public and does not diminish the importance of personal safety measures one should take to avoid infection and spread of the disease: Practice frequent and effective hand-washing, continue social distancing, and wear face masks when in public," she said.
Regardless of how long the COVID-19 pandemic lasts, patients will still need to receive routine and catch-up immunizations for other infectious diseases. It's important, said Rockwell, that FPs discuss immunizations with patients in a direct, sincere way that eases their concerns.
"For the vast majority of people, the benefits of vaccination so far outweigh the risks that discussion about vaccination must stress the potential harm that may befall a patient due to disease, rather than the minimal risk involved with vaccination," she said. "It is imperative that physicians use a presumptive approach in recommending vaccines, assuming patient acceptance, allaying any doubts about vaccine importance and safety. Questioning patients can be assured that vaccines are under continuous scrutiny and undergo years of safety testing and continuous monitoring."
To answer patient questions about vaccines, Rockwell recommended that FPs review a collection of resources(www.cdc.gov) published by the AAFP in collaboration with the CDC and the American Academy of Pediatrics, as well as materials from the Immunization Action Coalition.(www.immunize.org)
The Academy also offers a wealth of immunization resources for members. Most recently, the AAFP Board of Directors recently approved a statement, "COVID-19: Guidance for Family Physicians on Preventive and Non-Urgent Care."(121 KB PDF) Among other things, the statement notes that some FPs may not be able to provide preventive health care visits, including administration of immunizations. If only limited well-child visits can be provided, FPs are encouraged to prioritize newborn care and vaccination of infants and young children (through age 24 months) when possible.
Finally, Rockwell commented on the crucial role FPs will play in not only administering vaccines but also providing high-quality patient care during the pandemic and beyond.
"It is likely that the practice of medicine and how health care is delivered will forever change in dramatic ways going forward. The social distancing and shelter-in-place mandates proscribed during this historic time as our U.S. COVID-19 infection rates continue to rise and death tolls defy many predictive models necessitate that medicine be delivered by virtual methods: via phone calls, electronic portal messaging, and/or video visits.
"Family physicians, essential to the delivery of health care to all ages, genders, medical conditions and socioeconomic classes in this country, are trusted sources of information and healing for their patients," Rockwell added. "FPs are quickly adapting to this 'new normal' of health care delivery and are essential in maintaining the health and well-being of our country. The importance of vaccination against all known vaccine-preventable diseases was never so important as it is now."
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Respond to Coronavirus (COVID-19)
CDC: Advisory Committee on Immunization Practices: ACIP Recommendations(www.cdc.gov)