Path to Improved Health for Seniors

FamilyDoctor.org

Please share these important preventive health care services with your older adult patients and their families:

  • Annual wellness exam: Visit your doctor once a year for a physical. He or she will measure your height, weight, and body mass index. Your doctor will talk with you about any medicines you’re taking, your eating habits, and your activity level. This exam is a good way to check your overall health.
  • Influenza vaccine: This yearly vaccine helps prevent influenza (the flu). Older adults should get this vaccine every year. Between 70 and 90% of the deaths from influenza are in people 65 years of age or older.
  • Pneumococcal vaccines: The pneumococcal polysaccharide vaccine (PPSV) and pneumococcal conjugate vaccine (PCV13) are both important to help prevent pneumonia. For people who have pneumonia, it helps prevent life-threatening complications. This is especially important for older adults. They are more likely to get pneumonia and develop complications.
  • Breast cancer screening: The risk of getting breast cancer increases as you get older. More than 40 percent of all new breast cancer cases are in women 65 years of age and older. Women between the ages of 50 and 74 should have a mammogram every 2 years to screen for breast cancer. Depending on your breast cancer risk factors, your doctor may recommend you have a mammogram more often.
  • Colorectal cancer screening: Sixty percent of new colorectal cancer cases are in adults 70 years of age and older. The AAFP recommends screening for colorectal cancer with fecal immunochemical tests, flexible sigmoidoscopy, or colonoscopy starting at age 50 years and continuing until age 75 years. The risks, benefits, and strength of supporting evidence of different screening methods vary. Your doctor can discuss options for the type of screening tests available.
  • Diabetes screening: Diabetes is very common in older adults. It affects 1 out of every 4 adults 65 years of age and older. If you are overweight or obese, your doctor may test you for diabetes, even if you don’t have symptoms.
  • High Blood Pressure Screening: The possibility of developing high blood pressure increases as you get older. Your doctor will probably check this each time you are in the office, and at least once a year.
  • Cholesterol screening: High cholesterol is a risk factor for heart disease and stroke. Men 35 years of age and older should have their cholesterol levels checked on a regular basis. Women 45 years of age and older who are at risk for coronary heart disease should also be tested. Cholesterol levels are checked with a blood test.
  • Osteoporosis screening: The risk of osteoporosis increases as you get older. Women who are 65 years of age and older should be tested for osteoporosis. This test is called a bone mass (or bone density) test.

2019–20 Influenza Season Recommendations Released

CDC

The CDC has released Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2019–20 Influenza Season in the August 23 issue of MMWR Recommendations and Reports. The summary section is reprinted below.

This report updates the 2018–19 recommendations of the Advisory Committee on Immunization Practices (ACIP) regarding the use of seasonal influenza vaccines in the United States (MMWR Recomm Rep 2018;67[No. RR-3]). Routine annual influenza vaccination is recommended for all persons aged ≥6 months who do not have contraindications. A licensed, recommended, and age-appropriate vaccine should be used. Inactivated influenza vaccines (IIVs), recombinant influenza vaccine (RIV), and live attenuated influenza vaccine (LAIV) are expected to be available for the 2019–20 season. Standard-dose, unadjuvanted, inactivated influenza vaccines will be available in quadrivalent formulations (IIV4s). High-dose (HD-IIV3) and adjuvanted (aIIV3) inactivated influenza vaccines will be available in trivalent formulations. Recombinant (RIV4) and live attenuated influenza vaccine (LAIV4) will be available in quadrivalent formulations.

Updates to the recommendations described in this report reflect discussions during public meetings of ACIP held on October 25, 2018; February 27, 2019; and June 27, 2019. Primary updates in this report include the following two items. First, 2019–20 U.S. trivalent influenza vaccines will contain hemagglutinin (HA) derived from an A/Brisbane/02/2018 (H1N1)pdm09–like virus, an A/Kansas/14/2017 (H3N2)–like virus, and a B/Colorado/06/2017–like virus (Victoria lineage). Quadrivalent influenza vaccines will contain HA derived from these three viruses, and a B/Phuket/3073/2013–like virus (Yamagata lineage). Second, recent labeling changes for two IIV4s, Afluria Quadrivalent and Fluzone Quadrivalent, are discussed. The age indication for Afluria Quadrivalent has been expanded from ≥5 years to ≥6 months. The dose volume for Afluria Quadrivalent is 0.25 mL for children aged 6 through 35 months and 0.5 mL for all persons aged ≥36 months (≥3 years). The dose volume for Fluzone Quadrivalent for children aged 6 through 35 months, which was previously 0.25 mL, is now either 0.25 mL or 0.5 mL. The dose volume for Fluzone Quadrivalent is 0.5 mL for all persons aged ≥36 months (≥3 years).

This report focuses on the recommendations for use of vaccines for the prevention and control of influenza during the 2019–20 season in the United States. A brief summary of these recommendations and a Background Document containing additional information are available at https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/flu.html. These recommendations apply to U.S.-licensed influenza vaccines used within Food and Drug Administration–licensed indications. Updates and other information are available from CDC’s influenza website (https://www.cdc.gov/flu). Vaccination and health care providers should check this site periodically for additional information.

NIAM Features #HowIRecommend Vaccination Video Series, plus CME activities for YOU

CDC

Thank you for your support of National Immunization Awareness Month (NIAM) in August by encouraging your patients to be up to date on recommended vaccines.

Check out this new resource, #HowIRecommend Video Series, which offers simple and practical guidance for having successful vaccine conversations with parents and patients. These short videos demonstrate how to make effective vaccine recommendations, address common vaccine questions, and take a team-based approach to vaccination.

CDC has also developed Medscape CME activities to help healthcare professionals have successful conversations with parents about vaccines. Access these CME activities:

Kansas HPV Vaccine Rates Improve Significantly

KDHE

The National Immunization Survey regarding teens released its annual report for 2018 which shows Kansas is improving in vaccine rates for HPV and MenACWY and remaining consistent with Tdap. This report is available in the Morbidity and Mortality Weekly Report from the Centers for Disease Control and Prevention.

The survey, which is conducted among teens ages 13 to 17, monitors the vaccines received by adolescents, specifically HPV, MenACWY and Tdap.* “In 2014, Kansas had the lowest coverage in the nation for the HPV vaccine with only 34.4 percent of respondents reporting one or more doses received,” said KDHE Secretary Lee Norman, MD. “I’m very pleased to report that Kansas is now at 62.3 percent coverage in 2018, up significantly from 52.4 percent in 2017.”

Kansas has seen an average increase in HPV coverage of 6.3 percentage points annually since 2014 while the national average increase has been 4.4.

*Vaccine Description:
1. Tdap – protects against tetanus, diphtheria and pertussis. The vaccine is recommended for children ages 11-13. The Healthy People 2020 target is 80 percent coverage. Kansas’ 2018 rate is 89.4 percent.
2. MenACWY – protects against certain strains of meningococcal disease. This vaccination is recommended for patients ages 11-13 with a booster dose at age 16. The Healthy People 2020 target is 80 percent. Kansas’ 2018 rate is 75.3 percent.
3. HPV – protects against HPV-related cancers. Two-dose series are recommended for ages 11-13. Doses should be administered six months apart. If the first dose is not given before 15th birthday, a three-dose series is needed. The Healthy People 2020 target is 80 percent. The Kansas 2018 rate is 62.3 for one or more doses.

Vaccine Videos Available

Centers for Disease Control and Prevention

When it comes to vaccination, parents trust your expertise more than anyone else. Watch the CDC’ s latest videos on the topic. The #HowIRecommend video series features short, informative videos from clinicians like you. These videos explain the importance of vaccinations, how to effectively address questions from parents about vaccine safety and effectiveness, and how clinicians routinely recommend same-day vaccinations to their patients. Learn more here.

Make an Effective Vaccine Recommendation during National Immunization Awareness Month

Centers for Disease Control and Prevention

August is National Immunization Awareness Month (NIAM). This annual observance highlights the efforts of family physicians to protect patients of all ages against vaccine-preventable diseases through on-time vaccination.

During NIAM, Kansas Academy of Family Physicians encourages you to ensure your patients are up to date on recommended vaccines. Research has consistently shown that physicians are the most trusted source of vaccine information for parents and patients.

Use NIAM as an opportunity to access CDC educational resources like the Growing Up with Vaccines, What Should Parents Know and Medscape CME activities to help you have successful conversations with parents about vaccines.

The Public Health Foundation and CDC have developed a digital communication toolkit with messages and graphics tailored to your role as a family doctor and emphasizing the importance of vaccination for your patients. Show your practice’s support of vaccination throughout the month by using this content on your website and on social media. During NIAM and beyond, you can engage with CDC and other healthcare professionals on social media by using #ivax2protect in your posts.

Hep A and Meningococcal Vaccines to be Required for 2019-20 School Year

KDHE

Two new vaccines will be required for school-age children for the 2019-20 School Year: Meningococcal and Hepatitis A. The Kansas Department of Health and Environment proposed changes to the vaccine requirement regulations earlier this year and held a public hearing, concluding a 60-day public comment period in June. The regulations were approved by KDHE and will go into effect – Aug. 2.

Changes for 2019-20 School Year:

  • Students entering Kindergarten and Grade 1 for the 2019-2020 school year now need two doses of the hepatitis A vaccine.
  • Students entering Grade 7 for the 2019-2020 school year need one dose of the meningococcal ACWY vaccine.
  • Students entering Grade 11 need one dose of the meningococcal ACWY vaccine if not vaccinated prior to their 16 birthday. They will need two doses if their first dose was before their 16 birthday.

Vaccine requirements for schools can be found online at http://www.kdheks.gov/immunize/schoolInfo.htm

Read the full release at 2019-20 School Year: Meningococcal and Hepatitis A.

CDC and WHO publish “Genetic Characterization of Measles and Rubella Viruses Detected Through Global Measles and Rubella Elimination Surveillance”

CDC

CDC published Genetic Characterization of Measles and Rubella Viruses Detected Through Global Measles and Rubella Elimination Surveillance, 2016–2018 in the July 5 issue of MMWR (pages 587–591). On the same day, WHO’s Weekly Epidemiological Record published a similar article titled Genetic Characterization of Measles and Rubella Viruses Detected Through Global Measles and Rubella Elimination Surveillance, 2016–2018. The Summary box content from the MMWR article is reprinted below.

What is already known about this topic?
Monitoring progress toward measles and rubella elimination requires high-quality case-based surveillance, including genetic characterization of measles viruses and rubella viruses.

What is added by this report?
During 2016–2018, the number of reported measles virus genotypes declined from six to four; two (B3 and D8) accounted for 95% of reported sequences. Of 13 rubella virus genotypes, reported genotypes declined from five to two.

What are the implications for public health practice?
Diversity of measles and rubella viruses has decreased globally, consistent with progress toward elimination. Continued collection of specimens from all confirmed cases for genotyping and submission of wild-type virus sequences to global databases will strengthen case-based surveillance.

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Rep John Eplee, MD Speaks at Public Hearing on School Immunization Requirements

Immunize Kansas Coalition

The public hearing for the proposed regulation changes regarding vaccination for school entry was last week. Thank you to all who provided comments.

Thank you to  Representative John Eplee, MD, FAAFP, who presented his support for meningococcal immmunization and Hepatitis A immunizations as a school requirement last week at the hearing.

Full information is available regarding:  Proposed Regulation, Economic Impact Statement

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CDC Immunizations Information Systems Vaccine Code Updates

National Center for Immunization and Respiratory Diseases

The following Registry ISS codes have been updated and available. Please share with your office staff.

Read more