The drop in vaccination rates is understood to be a side effect of the “stay-at-home” orders issued in the spring of 2020. These freefalls have yet to be addressed in any meaningful way.

Vaccination Rates by Age

While vaccination rates have declined overall (indicating that our entire patient population will need a refresh), some age groups and demographics have been hit harder than others. In a recent study VaxCare conducted, which was cited by the National Foundation for Infectious Disease, we found that non-influenza vaccine rates for adults aged 65 and over had dropped 83% when compared to 2019. The decline for people aged 19–49 also came in at an eyebrow-raising rate of 60%. Across younger cohorts, this report from Avalere Health with support from GSK found that overall vaccination rates had dropped 41% and 53% for teens and adults, respectively.

Insurance Claims Tell the Story

Another indicator in the drop of vaccination rates can be found in the decline of claims submitted for vaccinations. While all insurance providers saw a decrease overall, we saw an even larger decline in commercial insurance or Medicare Advantage over Medicaid and Medicare. The largest drop on record was for adolescents served by commercial insurance, a whopping 86%. This chart from the Avalere study illustrates just how significant these drops were.

An Increase in Influenza Vaccinations

Despite the dramatic decline in traditional vaccination rates, one anomaly stands out: the rates for the influenza vaccine actually increased overall during the pandemic. Experts believe that the concern around COVID-19 infection, coupled with increased messaging about the flu vaccine, worked together to boost adherence for this year’s influenza vaccine.

This year’s rates will be even harder to predict than in last year’s, but we’re on the case. Watch this space for updates.

The post Non-COVID Vaccination Rates Plummet During the Pandemic appeared first on VaxCare.

Note that while the COVID-19 vaccine presents a lot of variables and challenges to administration, it also presents an opportunity for important personal connections during this difficult time. As healthcare professionals, you are in a unique position to offer reassurance, information, and a public health service to the community.

Now, let’s get to your questions.

Can my office be reimbursed for COVID-19 vaccine administration?

Yes. As part of the public health emergency phase, the federal government has made COVID-19 vaccines and boosters free to the public while allowing practices to bill for administration of the doses.

Your office will be able to bill a fee for the administration of each dose of the vaccine that will be paid by the patient’s private insurance, their public insurance, or by a Provider Relief Fund that has been set up for uninsured patients.

While originally there was a higher payment for the second dose of a COVID-19 vaccine, as of March 15, 2021, rates were set at $40 per each dose of the two-dose series and $40 for single-dose vaccinations, including boosters. Please check the CMS website for the most up-to-date rates.

How do I code for the administration of the COVID-19 vaccines?

Distinct codes have been provided for each vaccine manufacturer and for each dose. Unique coding of both vaccine and dose was set up to allow detailed tracking and reporting on the vaccine rollout as well as the efficacy of each particular vaccine by the AMA.

LINK: Find Your COVID-19 Vaccine CPT Codes at the AMA’s Website.

As with any new vaccines or administration codes, best practice is to review your payer contracts to ensure additional work is not required to add these CPT codes to your fee schedules.

How do I code for the administration of COVID-19 vaccines?

Distinct codes have been provided for each vaccine manufacturer and for each dose. Unique coding of both vaccine and dose was set up to allow detailed tracking and reporting on the vaccine rollout, as well as the efficacy of each particular vaccine, by the American Medical Association.

LINK: Find Your COVID-19 Vaccine CPT Codes at the AMA’s website.

As with any new vaccine or administration codes, best practice is to review your payer contracts to ensure additional work is not required to add these CPT codes to your fee schedules.

How do I store the COVID-19 vaccines?

Not all vaccines have the same storage requirements, so it’s important to make sure you understand the storage needs for each vaccine and how they relate to your office.

Pfizer-BioNTech COVID-19 Vaccine

Once a point of use (POU) receives a thermal shipper with our vaccine, they have multiple storage options:

• Ultra-low-temperature freezers, which are commercially available and can extend shelf life for up to six months.
• Pfizer thermal shippers, in which doses will arrive, can be used as temporary storage units for up to 30 days by refilling with dry ice every five days.
• Refrigeration units that are commonly available in hospitals and pharmacies. The vaccine can be stored for two weeks at temperatures between -25°C and -15°C.
• The vaccine can also be stored for up to one month (31 days) at temperatures between 2°C and 8°C.
• Once thawed and stored at temperatures between 2°C and 8°C, the vials cannot be refrozen or stored under frozen conditions.

For more details and information on storing the Pfizer-BiOnTech vaccine, see its COVID-19 Vaccine U.S. Distribution Fact Sheet.

Moderna COVID-19 Vaccine

Moderna’s COVID-19 vaccine will arrive frozen at temperatures between -50°C and -15°C (-58°F and 5°F). They can remain frozen until their expiration date.

Vaccines should be thawed in preparation for use. A POU can:

• Thaw in a refrigerator from 2°C to 8°C (36°F and 40°F). 5.5 mL vials should be thawed for 2.5 hours, while 7.5 mL vials should be thawed for 3 hours. Vials should then sit at room temperature for 15 minutes immediately before use.
• Thaw vials at room temperature between 15°C and 25°C (59°F and 77°F). 5.5 mL vials should be thawed for 1 hour, while 7.5 mL vials should be thawed for 1.5 hours.
• Vaccines should not be stored on dry ice or below -50ºC (-58ºF) and should remain in the original carton to protect from light.

After vaccines are thawed in preparation for use, they can then be stored at the following times at the following temperatures:

Unpunctured vials:

• 30 days: refrigerated at 2º-8ºC (36º-46ºF)
• 24 hours: cool storage up to room temperature at  8º-25ºC (46º-=77ºF)

After the first dose has been withdrawn:

• 12 hours: cool storage up to room temperature as defined as 2º-25ºC (36º-77ºF). Record the date and time of first use on the vial label. Discard punctured vial after 12 hours.

Thawed vials of vaccine cannot be refrozen.

For more details and information on storing the Moderna vaccine, see its Storage & Handling Guide.

JNJ-78436735 COVID-19 Vaccine

The COVID-19 vaccine from Johnson & Johnson differs from the Moderna and Pfizer vaccines in one key way that impacts storage. Where both Moderna and Pfizer have based their vaccines on mRNA technology, the JNJ vaccine is based on double-stranded DNA technology (similar to the Ebola vaccine approved in July 2020). The DNA is delivered inside a modified adenovirus, and these two elements together make it a more “rugged” vaccine than the mRNA-based Pfizer and Moderna vaccines. As such, the refrigeration requirements are not as demanding. 

• The vaccines arrive in a 2°-8°C (36°-46°F) qualified shipping container.
• Unpunctured vials can be stored between 2°C and 8°C (36°F and 46°F) until their expiration date. ‚ 
• Punctured vials can be stored between 2°C and 8°C (36°F and 46°F) for up to 6 hours. Note the date and time the vial was first punctured. Discard vaccines not used within this time. 
• Vials should not be frozen or exposed to light.

For more details and information on storing the Johnson & Johnson vaccine, see its Storage & Handling Summary.

Need help managing your COVID-19 vaccinations?

Our COVID-19 Assist program can help you manage, track, and bill for immunizations you administer, easing the burden on your practice and giving you a better view into your patients’ COVID-19 immunization stats. Tools such as our Mobile Hub and Event Registration App can also bring greater flexibility and ease to vaccinating your community. Get in touch to learn more!

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We knew the stay-at-home orders were going to have an effect on our pediatric and family medicine practices. However, none of us could foresee what a devastating impact the pandemic would have on our immunization programs and how it would put our otherwise healthy patients—young and old—at risk.

The reduction in immunizations post-Covid, as documented by Scientific American, is shocking: During the month and a half after the World Health Organization (WHO) declared a pandemic, states’ immunization rates plummeted; in some states, the rates were 60% lower than the same month in 2019. In fact, the WHO and UNICEF issued a statement calling the drop in vaccinations “alarming.” And doctors around the country started to fear that the lack of immunizations could spark new epidemics of vaccine-preventable diseases.

After pulling together to do our best to flatten the pandemic curve, the country began reopening in early June—but our offices remained quiet. Yes, some patients came back, but it was typically for treatment, often via telehealth, rather than for preventive services like annual physicals or well-child exams. And though our vaccination rates rebounded ever so slightly over the summer, current rates remain well below 2019 figures. With virtual patient visits becoming the norm, we’re worried this trend won’t be changing anytime soon.

And now with the flu vaccine season upon us and more states loosening their quarantine restrictions, there is a potential that we’ll be dealing with a “twindemic.” That’s why it’s absolutely critical that we do whatever we can to increase both awareness of and access to immunizations.

I’ve been in practice long enough to remember treating children with some of these horrific diseases. Even if you haven’t seen these diseases in your own practice, I know you share my passion for not returning to a time when a person could die from something we could have easily prevented with an immunization.

Searching for silver linings

In the Covid-19 era, we can—and must—look for silver linings, and here’s one I’ve found: the pandemic has, paradoxically, shone a bright light on the importance of immunizations. It’s also renewed interest in improving the data infrastructure and communication around immunizations. But you don’t have to be in a lab working on a vaccine or in your state capitol working on vaccine policy to play a role in this crisis. You’ve got the power to change things for the better, right from your office.

Take action

Here’s how you can play a part in narrowing the immunization gap in your practice and better serve your patients and your community:

• Create a “culture of immunization” in your practice to get everyone on your staff educated, inspired, and activated to meet the challenges of this unprecedented time.
• Take extra care to stay up-to-date on this year’s influenza vaccine recommendations.
• Develop a plan to educate your patients (or their parents) about the importance of vaccines, in general, and this year’s flu vaccine in particular.
• Be proactive and make a personal recommendation about immunizations to your patients: “You’re important to me as a patient, and I want you to get this vaccine.” The patient can always say no, but your words have power.
• Seize the moment: Always check your patients’ immunization schedules, even if they are in your office for something else. If they’re due, get the immunization done during that visit; don’t make them come back. The CDC is recommending that ALL due and overdue vaccines be given in that visit unless medically contraindicated.
• For your pediatric patients without private insurance, make sure they know about the CDC’s Vaccines for Children program that helps them access vaccines at no cost. If you are not a VFC practice, make sure your pediatric patients can access vaccines at alternative locations, such as at your local health department.

I like to think that Covid-19 could be an inflection point, one of those rare pivotal moments where we have the opportunity to fix our ailing immunization infrastructure and, more broadly, what’s ailing health care. Instead of giving in to pessimism, frustration and fear, we can use the pandemic as an opportunity to rethink and redesign our healthcare system and put the focus back where it belongs—on primary care and on our patients.

The post Covid-19 Is Threatening Vaccination Rates. Here’s How to Help. appeared first on VaxCare.