Leading the Way to a Healthier Winter: A Conversation for Clinicians on Flu, COVID-19, & RSV Vaccine

all right thank you for joining cdc's briefing leading the way to a healthier winter a conversation for clinicians on flu covid-19 and RSV vaccines my name is Betsy weand and I'm the public health policy adviser in the office of intergovernmental and external Affairs here at the Department of Health and Human Services this briefing is open to the public however the conversation should be considered off the Record and any press inquiries for HHS should be directed to the Press office at media hhs.gov there will be time at the end for Q&A so we encourage you to submit your questions using the Q&A function at the bottom of your screen at any time during the briefing I'd now like to welcome today's moderator Dr Charlene Wong senior adviser for health strategy to director Cohen at the Centers for Disease Control and prevention Dr Wong the floor is yours thank you so much Betsy hello everyone I am so pleased to be here today and welcome you to this important conversation for all of us who are clinicians Healthcare professionals about how we can protect ourselves our patients and our communities this fall and winter viral respiratory season as we are expecting to see the usual upticks in flu covid-19 and respiratory sensial virus or RSV uh we as Healthcare Providers play Such important such an important role um in protecting ourselves our patients and our communities we are proud to be hosting this event today in collaboration with the US Department of Health and Human Services riskless do more Campaign which helps people risk less severe illness and do more of what they enjoy this fall and winter viral respiratory season and we do this by sharing information and encouraging uptake and answering questions about flu covid-19 and RSB vaccines and other testing and treatment our other co- host today include the American Medical Association the American Nurses Association the American Academy of family physicians and the American pharmacist Association we're joined today by a great group of experts from each of these organizations who will share their perspectives from their professional with their professional communities so we have Dr Sandra fryhofer who is an internal medicine doctor and Is On The Board of Trustees of the American Medical Association and is the amas liaison to the acip committee next we have Holly Carpenter who is a registered nurse who has practiced for many years and serves as the senior policy adviser at the American Nurses Association Next we have Dr Elizabeth skoy she is a community practicing Community pharmacist and is a fellow of the American pharmacist Association she also serves um as apa's representative to one of the acip work groups on RSV and finally we have Dr Jen Brule who is a family medicine doctor and is president of the American Academy of family physicians we'll be getting into a question and answer session with this group of experts shortly some of you all submitted a question when you registered for this webinar today you can we are going to be getting to as many of those as possible we will also be inviting you to ask questions during this webinar and you can use the chat function or the Q&A function in order to put that those questions in finally I'd like to introduce Captain Kevin chadam Stevens who is also a physician who is going to kick off the webinar with sharing some of the latest on the recommendations latest data for what we can all be doing to help protect ourselves our patients and our communities Dr chadam Stevens great thanks so much really appreciate the opportunity to chat with you all today we we definitely understand everyone quite busy um but we feel strongly about getting the message out there as we head into um the holidays and what we anticipate will be a more respiratory viral activity and so starting off really wanted to highlight as Dr Charlene mentioned the risk less do more campaign I think we're all very excited about this important public education campaign to really help contribute to reducing the effects that respiratory viruses have on people every year and so I think we all understand that flu covid and and RSV vaccines can help people risk less severe disease and do more of what they enjoy and yet unfortunately many people are unaware of the tremendous benefits of these vaccines and so that's why ajj launched the risk L do more campaign and the purpose is really to help inform key audiances about the risks of respiratory viruses and really Empower themelves to empower themselves to protect themselves from a flu covid and RSV so let's go on to the next slide please so to really help frame this presentation I'll start with this CDC fall and winter immunization infographic as you can see it summarizes the vaccine recommendations for covid flu and RSV across a lifespan um from peeds at the top to older adults down at the bottom and for Co and flu those recommendations are relatively simple um those are that everyone in six months of age and older should get a covid and flu vaccine especially those people who are at increased risk of severe disease such as infants older adults and those with underlying medical conditions and as noted on the slide there are some nuances outlined um for the Pediatric and older adult populations and we'll get into those in a bit more detail so in addition over on the right hand side of the slide we're really fortunate now to have new immunization products for RSV and so there are now two ways to help protect infants from severe RSV disease one is nura map um and this is a monoclinal antibody that all infants under eight months of age and some infants between the ages of eight months and and 19 months with certain risk factors should get during October through March for most of the continental US so that's one way the second way is the maternal RSV vaccine which should be given to pregnant people at 32 through 36 weeks of gestation during September through January once again in most of the continental US and up note the only RSV vaccine that's licensed for the use in pregnant people is fisers or brisbo and now we're also fortunate to have three RSV vaccines for use in adults 60 years and older so the recommendation here is that all adults 75 years and above and certain adults 60 years through 74 years with risk factors should get a single RSV vaccine dose so once again hopefully this infographic is helpful in just quickly summarizing the recommendations for the vaccines next slide please so while we're focused a bit on covid flu and RSV vaccines for this presentation we also wanted to note a recent revised recommendation for the numoco vaccine that you may have heard of so the previous recommendation was that adults 65 plus who hadn't yet received a numoco conjugate vaccine should get one but in October um acip recommended lowering that age recommendation down to 50 years so we've highlighted that here in addition acci also recommended additional doses of the covid-19 vaccine for certain populations and those are noted on the slide here so in addition to that General recommendation that everyone six months of age and older should get um an updated a dose of the updated 2024 to 25 covid-19 vaccine ecip recommended a second dose um for adult 65 plus also recommended a second dose for people ages 6 months through 64 years of age who are moderately or severely imuno compromised so those two populations should get two doses uh this season and they also made a another recommendation under the share clinical decision-making approach that people who are moderately or severly imuno compromised can get additional doses right in discussion with the patient so we just wanted to highlight some of those more recent recommendations next slide please so also wanted to highlight kind of where we stand right now at this moment so you know today is Thursday November 21st and so where do we stand when it comes to covid flu and RSV and what we have on this slide is emergency departments for Respiratory viral illnesses and these are the percentage of all um Ed visits you can see Co is in the orange uh flu is in the blue and then RSV is in that burgundy color um and you know looking back to December January of uh you know 2023 to 24 you can see that typical Spike that we oftentimes will see with flu and covid um kind of spiking together and then in kind of late summer early fall we had that summer wave of Co that you see there in Orange and the good news is that we're kind of in a low like overall flu and covid activity is fairly lower stable emergency department for RSB are starting to increase and we're definitely hearing increases in certain parts of the country as well from our Ed um colleagues but I think this just reiterates that during this time where we're not seeing a tremendous amount of respiratory virus activity Now is really the time to prepare and get um yourselves and our patients vaccinated um those who have not been vaccinated already so next slide please and so this is another resource that we really wanted to highlight you all um so this is our respiratory virus dashboard it has a lot of helpful information so you can go in there and get information at the national level as well as drill down to your specific uh County and see how things are going in your community so you can see things like what's going on with Wastewater um and then also emergency department visits as well and it it provides some general um uh categories of how things are going right are is respiratory virus um activity minimal is it um low is it high Etc so we definitely encourage you to to explore this resource um next slide please one other thing that it leaks out to so from that respiratory virus dashboard you can kind of see where vaccination stands and it will link out to other Pages similarly where you can see the national uh landscape and then you can drill down often times to state level um vaccination coverage depending on the vaccine and the data source so here we're just briefly showing where we stand uh in terms of adult coverage for covid-19 vaccine on the left and flu um vaccine coverage on the right um and you can see that we have two years here um so green is this year and then the light blue is last year for both of those vaccines so for a covid vaccine we're a bit above where we were last year which is obviously fantastic news approaching almost about 20% of adults being vaccinated uh for covid with the updated 2024 to 25 vaccine then over on the right you can see flu is pretty much tracking this year compared to where it was last year we have just above a third of all adults have gotten a flu vaccine this year I will note that unfortunately you know this is below where we were pre pandemic so even though we're doing the same as last year we still have some opportunity um to improve and kind of return to where we were pre pandemic next slide please great so that was the overall adult population in the United States so here what we're looking at is drilling down and looking at um healthc care provider vaccination coverage so this was from 23 to 24 so this previous um season and what we're looking at is flu on the left and covid on the on the right and this is the percent of healthc care providers who were vaccinated against flu and against covid and you see that we have data from two different sources is the blue is um the national healthc care safety Network NH HSN and then the green is an internet panel survey so nhsn is when healthc care facilities report data directly to CDC and the internet panel survey is when Healthcare Providers you know rep self-report their vaccination status to CDC through this survey so they they're different uh data sources so not directly comparable but we are uh including both of them here for context and at a high level what you basically see is coverage for flu is greater than coverage for covid and then within both of the or for flu at least coverage in acute care um settings so such as hospitals is much higher than um coverage in long-term care facilities and as you can see for flu we're doing fairly well um in the acute care settings with um coverage somewhere in the 80% range it's lower for long-term care facilities anywhere from just under half to about 2/3 and then for covid you can see those rate those coverage percentiles are much lower so anywhere from you know 15 to% to 34% for acute care facilities and then similarly 11 to 35% among long-term care facilities as well so I think this is really a great call to action that we all um you need to be vaccinated for flu and covid um during this respiratory virus season next slide please so here are just some reasons why we definitely want Healthcare Providers to be up to date with their vaccinations I think obviously none of us wants to miss the things that we love to do so um we we don't want to have to miss any more holidays or events with family and friends I think we all have numerous instances in when in which case that's happened over the preceding several years from covid flu or other respiratory viruses so we want everyone to be protected to be able to spend that time with their family and obviously we also want our healthc care providers to be protected so that they can do what um they do day in day out and that's helped take care of our patients right and so healthy Health Care Providers um are are able to take care of their patients right and even though many of us as health care providers may not have underlying Healthcare uh underlying health conditions at places that increase risk of severe um disease from from these respiratory viruses we know obviously know that many of our patients do and so we want to make sure that we're not transmitting any of these viruses to our patients and placing them at risk and just one um you know one nugget of information that you can use is many of these vaccines help cut our chances of getting very sick by about half right which is profoundly important to relay not only to other healthc care providers U but to our patients as well next slide please so um along those lines you know the things that we can do to help protect ourselves and our patients right when we're having conversations with our patients they obviously look up to us in a lot of instances and they will will take our lead right I think we all have instances in which a patient has asked us for guidance like hey what would you do if you were in my situation whether or not they're thinking about a specific treatment course or maybe they have some concerns about a vaccine they're asking you um what you would do right and so I'm a pediatrician so I've had you know many conversations with parents um and sometimes about vaccines and sometimes those parents will ask me well you have kids like are your children vaccinated and so I can relay my personal experience to them regarding having our kids up to date with their routine vaccinations getting them the covid-19 vaccines Etc and I think you all uh just to reiterate this point hopefully you all know it but you all are humorous uh your patients most trusted source of information right and so what you say really carries a lot of weight in patients decision-making processes we definitely understand that there's some fatigue out there we've all been through a lot collectively over the past several years so many people don't even want to kind of talk about um covid or any of these respiratory viruses right so we understand that but we we definitely want to balance that with um you know bringing these uh respiratory viruses up and making sure that patients are protected against them and um I think you know just the last point there is that you know you may be the sole person to bring this up um to your patient right because of that fatigue there's not a lot of conversation going on in our communities regarding some of these vaccines and so you you all are a prime opportunity um to bring up these vaccines and the importance of getting vaccinated next slide please so one other piece of data that we wanted to share um is that covid-19 still represents a public health and clinical threat to our patients um and what this uh slide is showing is the percentage of all deaths in the US that are related to these respiratory viruses and you can see that Peak back in December and January from covid and flu um and then you can see the the more recent Peak once again in in late summer early fall from covid and the take home here is that about two to 4% of all deaths are still related to to covid-19 during these Peaks and waves and so even though we're in a much better position than we were back in 20120 2021 even 2022 um you know with um you know preexist with um protection from pre-existing infection with uh protection from vaccine we're in a much better space but we still want to reiterate that people are still unfortunately dying from covid-19 and so just another point that you can use to emphasize the importance of getting vaccinated next slide please so with that I wanted to continue to share some of the resources that are available to you all as healthc care providers and you've probably noticed um on many of these slides we have QR codes so you can definitely scan those and it'll link directly to these various resources so we have a v variety of clinical resources for each of these VI each of these viruses including the vaccine so flu Co and RSV also wanted to highlight in the middle there that there's this wonderful new uh short video it's only a couple minutes long that um you can share with your patients as well as other health care providers and it really walks through um the respiratory viruses um the vaccines and share some of the information that you can share with patients regarding the importance of these vaccines and and while I also note that you know this particular presentation has been focused on vaccination we definitely acknowledge the importance of early treatment as well as on the right there that QR code will link out to uh Co and flu uh treatment um resources as well next slide please so wanted to finish up the slides at least with a couple slides on uh the riskless do more campaign um and once again um this slide includes the target populations for the campaign you all as you can see in the upper left are a primary audience of this campaign for the reasons that we've talked about on the previous slides and so in addition without immunization the risk of serious illness from flu covid and RSV remains highest in certain populations including adults 65 plus as well as residents of long-term care facilities so both of those um populations are included as you can see on the slide and we also understand um that family members and other caregivers are very important in helping older adults make health decisions including the decision whether or not to get vaccinated so they're included um in this campaign as well in Additionally you definitely want to reduce the risk of flu covid and RSV among audiences with higher infection rates who sometimes also have lower access to health care resources and so the campaign also includes tailored messages for adults living in rural areas uh and black and Latino populations and as you can see on the slide pregnant people are also included to help protect not only themselves but also their babies and um just want to reiterate that our infants um for Co flu and RSV are oftentimes um some of the populations that are at the in at increased risk for severe disease and so the the risk L do more campaign just tries to offer resources to healthc care providers to support um patient education next slide please so the the risk L do more C pain really emphasizes that some people live with a greater risk of severe illness or death from these respiratory viruses really emphasizes that getting this season vaccines will help reduce that risk so that they can continue to do the things that they love it uses uplifting relatable unexpected messaging to reach at risk people and really connect preventive steps such as vaccines to meaningful moments in their lives um it's delivering research-based messages through a variety of avenues including paid advertising and media coverage on TV radio print um digital and other platforms and so we also want to ensure that audiences have access to information from sources they trust um so the campaign is also partnering with over 50 organizations at the national state and local level as well as with state and local Health departments to share facts about the vaccines that can once again help uh people avoid void severe illness next slide please just wanted to share a few examples of some of the social media ads that are in both English and Spanish and many of these are available on the riskless do more uh website next slide please so as I mentioned the campaign also has a comprehensive list of materials for healthc care providers to help amplify the campaign messages so this includes a variety of different resources uh fact sheets uh posters ads um you know there's draft copy that you can plug and play into your newsletters and talking points and as well as social media messages as well so these are all materials that you can take and use and adapt to your patient population next slide please so for those kind of one-on-one conversations with patients or with patients families campaign also produced um sample text messages and a conversation guide uh to really help healthc care providers have those vaccine conversations with patients and to help um answer some of the the common questions that we typically hear about flu covid and RSV vaccines and so some of these materials have been translated into a variety of other languages besides just English and Spanish um including chinese vietnamese as well as other languages next slide please so um that's our last slide just want to take this particular slide to encourage you all to go to the the website it's riskless do more. hhs.gov where you can find more information about the campaign including the variety of the resources that I mentioned uh so with that I'll turn it back to Dr Wong thank you Dr Kevin um thanks for all that wonderful information we're starting to get some question questions in the question and answer function already so please do be putting additional questions in there we are going to start with h bringing on our panelist if our panelist could please come on camera wonderful and so we're going to start with some questions um that also came in while during the registrations so let's start with this first one which is as healthc Care Professionals we bring our expertise we bring our own training our lived experience to our work um tell us a little bit about your own motivations for getting yourself vaccinated and perhaps your family vaccinated um Dr Sandra let's start with you uh thank you so much and I have to be honest when it comes to vaccination I'm a Believer I believe in the power of vaccination vaccines not only protect you but they also protect those around you and I practice what I preach I've gotten my flu shot I've gotten a dose of the updated covid vaccine I'm not a candidate for the RSV vaccination at this time but I'm up to date on all my vaccinations and here's why I'm in full-time Private Practice General Internal Medicine and I don't want to get sick and I need to be there for my patients and many of my patients have multiple medical conditions many are older and frail I get vaccinated to protect them I have a family member who will soon be undergoing chemotherapy I get vaccinated to protect them I'm also a new grandmother baby Fern is just five months old so she's still too young to be vaccinated for flu and covid so I got vaccinated to protect her her protection actually started before she was born her mother received a dose of covid vaccine during pregnancy so baby Fern got some antibodies from her mom and both her mom and her dad are vaccinated for both flu and covid to protect her now this is baby Fern's first RSV season and I was so relieved when she got her first dose of narab that long acting monoclonal antibody that protects babies from severe RSV and as you know we now have two ways to protect little babies from RSV maternal vaccination for moms who will deliver during RSV season and a Serv M for baby's under eight months old in their first RSV season and understand if you're young and healthy and if you get Co or you get flu most likely you'll be fine I sure hope so uh in fact you may not have any symptoms at all but if you pass your infection to someone older someone with multiple medical conditions or someone with an imuno compromising condition or to a little baby that infection could be life-threatening or life ending for them getting vaccinated against flu and covid and if indicated RSV is the right thing to do it's the responsible thing to do to protect yourself and those around you thanks so much Dr Sandra uh Dr Jen let's go over to you you're on mute Dr Jen the Fatal flaw I was going to try to MIM this for you um I would Echo all of Dr Sandra's reasons I think that the reasons that I choose to get vaccinated and that I encourage those around me are both profession and personal although I'm not in a clinical role at this moment I sure do see a lot of people in the community and as a person who is in the health care profession and a family medicine physician I want to be able to say proudly yep I got my vaccines as soon as they were available I have a person on the other end of the age Spectrum from Fern who I get vaccinated for my mom just turned 80 and yesterday she moved to an assisted living facility and when I think about her health and her living situation I want to make sure that I'm doing everything I can as one of her caregivers to never bring her an infection into that space because I already know that her risk is great so I'll end with adding those pieces thank you so much Dr Jen Dr Elizabeth yeah I would Echo everything that my colleagues have already stated um for their reasons but um as a practicing Community pharmacist the age ranges that come to see me on a daily basis range from newborn all the way to the quite elderly and I definitely get vaccinated and I encourage um my others in my profession and in my Pharmacy and I'm also a professor I encourage my students to all get vaccinated to really protect our patients that was already stated from The Young that can't yet get their vaccines particularly with influenza all the way up through the elderly um and in addition to all those patients that can't get back V inated themselves um at a personal level um my entire family gets vaccinated and I have three young children at home and we all um our entire family gets in the car and we go ahead and we get our vaccinations at the pharmacy on an on an annual basis and it's a it's kind of a you know an annual outing for us um and so and they actually have become um their own advocates for vaccination among their own friends and and so I think it's important as already Dr Sandra mentioned to really practice what we preach and and get ourselves and our own families vaccinated as well great and Holly as a nurse who are so often the people who were actually doing the vaccinations uh tell us about your experience and your reasons so my vaccin uh vaccination reasons are very similar to everyone else's obviously my family um I have older parents in their 80s um my husband's um older parents as well very young grandchildren um we'd love to visit so we we want to make make sure we don't bring any extras with us um any unexpected disease again as um uh I believe Dr fryhofer said you may feel you are not at risk but how could you live with yourself if you infected someone else and and and the worst happened they got ill or even um got long covid so also um I go to my place of worship frequently and there's a lot of older adults there as well as people pregnant um say with work um people with uh chronic illness underlying conditions so basically I get immunized and ask everyone else to get immunized for Humanity as a whole uh especially as health care providers it's the ethical and right thing for us to do thank you so much everyone and I'll just add my quick note agree with everything you all said I'm a pediatrician and I do it for all the reasons you all said and in addition you know I try to go earlier in the season including getting my kids vaccinated sort of as they are recommended in those ideal time frames in part because I do get asked by patients not infrequently well doc you know what did you do do you get your kids vaccinated and I love to be able to look right back at them and say yes I do you know and we have right and this is how we did it it was so easy uh you know we can get you vaccinated right here today in clinic all right let's go to our next question and um maybe we will start with Dr Jen you for this one you know what are you hearing about your from your colleagues uh you know our other clinical team members about what strategies can help support healthcare workers in getting their vaccine and I think we may end up touching actually on some of the questions that I see coming in in the Q&A now yeah I I would highlight three things I think the first is to lead by example you don't ever want to be encouraging someone to get their vaccine if you have not done the same or done the same for your family and those you love uh the second is to make it incredibly easy to say yes so have those vaccines available at the work site and for no cost and I think that really um eliminates some barriers and then the third is a little bit more complex of a strategy and that's that I always try to call people in to the space of vaccination rather than calling people out for not being in that space and I think inclusive curiosity is a really important way to approach those who have hesitant um as we saw during the Co pandemic um mandates didn't always work very well and they often resulted in burned out healthcare workers quitting rather than choosing to get a vaccine which reduced our Workforce so that's always been my strategy is to understand why people might be hesitant and to invite them into the space of moving forward with vaccination wonderful Dr Sandra what would you add well um many hospitals actually require flu and covid vaccination for their healthare workers but some do not and many hospitals offer free flu shots for healthare workers however Co and flu vaccines are easily available at most pharmacies so access for healthcare workers is not the issue it's making the time and getting it done and now is the time the best time to get the fu vaccination is in October but we're past that so if you haven't been vaccinated go today and get it done and wear a sleeveless shirt or make sure your sleeve can easily be rolled up to make Administration easier and I think many people worry about side effects from vaccination um I get it I understand I had a rough time with the with the first few covid vaccine shots but the last few shots have been fine in fact the last one was a piece of cake I didn't have any side effects at all and I was relieved after it was over I was so glad I had boosted my immune system for protection and when I was getting my shot I thought about all the people who had been hospitalized or died during the pandemic that's why we roll up our sleeves our country has been through so much during the pandemic we don't want to go back there another reason this year to get vaccinated for flu is the bird flu we don't want seasonal flu virus to mix and match with the bird flu virus and getting vaccinated against flu can help keep that from happening and you can get all the vaccines at different times or all at the same time but we're sort of running out of time respiratory infection season is here just do it get it done get it done today touch on that a little bit more which is some of those side effects like you were mentioning Dr Sandra you know one thing I like to say to my patients and you know to my colleagues is you know sometimes when you get those mild side effects maybe a little bit of a sore arm maybe even a little more than that it's a it can be a good F actually that the vaccine is working but Dr Kevin anything else that you would want to add on some of the types of side effects that we most commonly see or you know how we recommend clinicians talk about those side effects both with patients or our colleagues sure I think you know um one thing is just to if a patient is expressing um some discomfort with the vaccines I would just you know ask them what they're most concerned about I think that's always a great thing to do is to just try to figure out what they're most concerned about and if they are concerned about the side effects I think you know one thing that you can say especially from the covid standpoint is that you know while there are some side effects these are typically you know mild to moderate you know the severe side effects are quite rare and while we definitely don't want to minimize those the people's experience with mild or moderate side effects we do want to emphasize once again that you know serious side effects are rare for example you know I recently got or a couple months ago got my um updated 2024 to 25 covid-19 vaccine and the following day I did have some of those reactogenicity right the sore muscles the headache Etc so I think you know talking to patients about that letting them know that that's oftentimes over quite quickly within 24 to 48 hours um and that once again that's you know you have to balance that with the benefit of um additional protection from the vaccine so just a couple points there great and you know practical tip which is what I use is I do tend to get vacinated either on a Friday or Saturday so just in case any of those mild or moderate symptoms happen you're not doing dealing with those and working at the same time um for those of you who depending on what your clinical schedule looks like all right let's go to the next question and Holly uh and Dr Elizabeth these will be for you all for you two first is you know we're starting to get into this what do you think is the most important thing our patients need to hear from us as their clinicians as we are approaching the first set of the winter holidays hi thank you so much uh Dr Charlene the first and foremost is if you haven't gotten vaccinated yet and are eligible for the RSV covid-19 um or the flu immunization please get it now it's not too late um and you haven't missed a window of of opportunity go ahead and get it immediately and as we prepare for Holiday Gatherings this timing is really crucial we expect to see more of the vir uh viruses circulating as we get deeper into winter and then remember those that care for others and obviously we're talking about health care providers um and ourselves our colleagues but also those that care for others such as pregnant mothers those caring for young children caring for older family members with chronic underlying diseases those caregivers are crucial to also get their um respiratory viral vaccinations as well as those that they care for if they're eligible uh they absolutely must be protected uh from the respiratory viruses this season and then I I will kick it on uh to drct the next Doctor I thanks olly and just I think with with patients need to hear from us and what I think they like to hear from me or I hope they like to hear from me is just reminding them of their vaccine so we try to really advocate for looking in that immunization record looking in that Healthcare record to see if our patients when they're coming in for their visit when they're coming in for um you know medication management visit with the pharmacy or coming in to pick up a prescription to look to see in their in their record if they've had their immunization yet or not and then if they haven't then going and making that really strong recommendation you know saying hey I noticed that you haven't yet gotten your influenza vaccine today it's really important you do that I can go get it ready for you right now kind of giving that presumptive approach that yes everyone should get vaccinated and yes why would you you know of course you're going to get vaccinated too um and then of course if if they have questions or hesitancy addressing those particularly with those patients and and having that conversation with them but I think it's just it's asking it's making that strong recommendation and sometimes in our Pharmacy we have it just as a normal standard of practice with every patient have you have you gotten your flu vaccine yet today have you gotten your covid vaccine yet um and so having that kind of as a standard of practice every time we're visiting with our patients every patient every visit every encounter to asking those particular questions during respiratory season thank you guys so much all right um Dr Kevin I'm going to go to some of the Q&A that are coming into the chat so let me start with you uh it seems like there are several folks who are interested in knowing a little bit more about the numac vaccine um which you touched on at the beginning could you just say again you know who is eligible for that are there any contraindications for the num maaca vaccine great yeah thanks for that question so yeah the the the change that was made in October recommended by acip and then um you know recommended by or approved by Dr Cohen CDC director was essentially to lower the age limit from 65 to 50 so that was the major change and so this recommendation now is that um all adults o 50 years and older regardless of underlying medical condition right um should get uh the Paco conjugate vaccine and that's for those who have never received any prior conjugate uh Paco conjugate vaccine as well as um those whose previous vaccination status is unknown and this is really uh to help um prevent some of those pakle um manifestations that we're all familiar with unfortunately so pneumonia um bloodstream infections menitis Etc um and there are a lot of um nuances in the new makako vaccination recommendations especially for those um people who are at increased risk of severe disease um so I would point you towards the the CDC recommendations on there um just so that you can familiarize yourself with those based on your patient population and who you typically see great all right I'm also going to go to there are a couple of I'm going to call them patient scenario questions that have come in um so let me ask these and anyone on the panel uh can chime in so there 's a question about a family member who has chronic heart disease and had a cabbage done in 2008 has had arhythmia and had an MI about a year ago um has had a dry cough most of the winter season question can he get his flu shot he is over 60 anyone feel free to chime in Dr yes Dr resoundingly yes and uh should several times um I I've heard people say you know it we are approaching the holidays it's the end of November and of course a great time to get your vaccines is in October but vaccines are like that lovely saying which is the best time to plant a tree was 20 years ago or today and that's the same thing about vaccines if if you've waited until today it's okay go today get it get it done that's a wonderful thing to do for yourself and for those around you and all the rest of the family M also should get vaccinated and everyone who's going to be around this person because this person is at high risk for having severe disease wonderful all right next uh sort of patient scenario question what if I have a patient who is imuno compromised can they get their RSV vaccine if they're between 50 and 60 years old since the FDA approved it but there's not yet been an acip recommendation I think Dr Elizabeth you maybe could help answer this one yeah that's a really great great question and so uh there has been approval for a vaccine um in a younger age group than the acip is currently recommending and so the acip has re has made the recommendations for um 60 years and older and so although there is FDA approval for That vaccine that isn't necessarily preventing the patient so technically yes you could provide that vaccination to the patient because it would be prescribed under label however just realize that that's not an acip recommendation at this time and as well as that a lot of times insurance companies uh will not cover that just because that is not recommended yet all right wonderful all right let's talk about some common issues that uh we have that we all have had this experience I think in talking to our patients about vaccines um so Holly let's start with you and you know I think we get I get asked we get asked at the CDC you know like how do you start these conversations uh because sometimes you know we're asked to cover so much in a visit uh what are your best tips here for starting the conversation well first of all is clear direct language um for instance you could say something like it looks like you're due for your flu and covid-19 vaccines and you haven't had an RSV vaccine before because you're over 75 you're more likely to get very sick or need hospital care if you get one of these illnesses and these vaccines can cut your chances of being hospitalized by half so just being very upbeat and um kind of very matter of fact about it um direct and clear language cannot be overemphasized um as we saw in the beginning of our webinar today share your why and your personal experience you know yourself when you go in um to see a specialist you often say you know what would you recommend what would you do if this was your family member what would you do if this was you which we were also seeing today so share that you did get your vaccine and that you feel confident in it that you know it's safe and effective um another thing is is talking about um cutting that risk in half especially for uh flu and covid-19 knowing that yes it doesn't completely prevent the illness but it will um cut down on your severity if you do get it and cut down in your hospitalization um length of stay or hospitalization at all um ask very clearly if they have any questions or concerns and then be very very prepared to answer it um for example you know you can say well do you have a question and you and they say yes and you're like oh that's a good question let me get back to you on that well they're going to get back to you on that vaccine not so you definitely have to um definitely be prepared to to answer that and I know we talked a little bit about this before but HHS has that um wonderful guide called talking to your patients about flu covid-19 and RSV vaccines it is excellent um it has frequently ask questions so that you can be prepared and you don't have to do too much um on the front end and really hard questions um as well addressing vaccination um hesitancy misinformation disinformation and straight up fearfulness people are really scared um it gives several factual and downto Earth responses to assist you so you don't have to kind of plan out what you're going to say it also neatly lays out who and when should get these viral respiratory vaccines so it's kind of really a handy guide all the way around and just as a reminder that's part of the risk less and do more campaign also with patients especially as nurses we need to keep our patients trust acknowledge their fears respectfully while explaining that the vaccine that they're concerned about um is safe and efficient and effective and that you yourself have gotten it and recommend it for your family members as well um again can't overestimate sharing your experience I got these vaccinations and I make sure my family does as well and always remember we're trusted Messengers in a world full of mistrust and distrust so this is our chance and we've got to take it thank you so much Holly I love the way you put that let me ask a question that might be a little bit tough and I'll open it to the full panel and maybe Dr s if you want to kick us off you know I think probably most of us have had conversations where either you suspected or were surprised that you know the patient the family was uh you know quite strongly you know uh against vaccines or had like very serious concerns and just curious how you navigate that well I start off like I do with all my patients and I the the numon I use is called ases a for announce okay let's get your flu shot today it's time for you to get a covid vaccine uh you need the updated vaccine this is why the V the the um virus has changed a lot since this first since uh 2020 when we first became aware of it the vaccines are a lot different now than they used to be so just like you update your computer programs and your iPhone you've got to update your immune system to be to be ready to fight covid so that's a for anounce and if they have push back the I is for inquire like what are your questions what are you concerned about are you wored about side effects and we talk about well as we we heard earlier maybe get it on a Friday don't get it um right before you have some a big important presentation to give um M is for Mirror you know make sure that the patient understands that you understand their questions their concerns in a very non-judgmental way and then the S is for secure trust keep that line of communication open keep that conversation going um and encourage patients to check trusted sources of information like the CDC website and like the American Medical Association website I found that's really helpful and just keep the patients asking questions and I think we can eventually get them to understand how important this is any other additions to that I might just add that I I think it starts with your whole team helping the patient make this decision so um I love that we have Holly on this panel because when I was in practice for 20 years my nurses were often the people who gave the vaccines before I even got to the room and that really cut down on the barriers around getting a vaccine if it was available when they walked in the door and when they got their blood pressure they also got their flu shot uh so I I think calling in that big group of teamwork is important and then the second thing I would say is normalize conversation particularly in patients who are hesitant to get vaccinated so I talk to smokers all the time about whether they have a desire to quit smoking that day and many of them don't but I tell them I'm going to ask you every time you're here because it's really important to your health and it's really important to me and I like you and I want you to be healthy and so I'm going to ask you each time because if I didn't you might think I didn't think it was important and I think it's the same way when we talk about vaccine hases Y is I know that last time you told me no you turned me down but today I'd love to have that conversation again what are your hesitations what are the things you're worried about can can I share information with you about that and not necessarily pressure for a decision but offer them the opportunity to change their mind every time they see you I love that we actually recently oh sorry go ahead Dr Sandra also as a primary care physician you know I know a lot about what's going on in patients lives and so if they have a big trip let's say they're going to Europe that's a good time to say okay you don't want to get covid while you're in Europe because I won't be there with you that can sometimes help patients go ahead and get vaccinated and so just using whatever ever little trick you can just to connect that with something that's important you know we we talked about the importance of protecting our loved ones you know the your mother or father in a nursing home um a family member who might be undergoing chemotherapy just remind patients it's not only to protect them but also to protect those around them and if you use that heart approach I think it can really be helpful wonderful and I will add because Dr Kevin did show us those data that we ourselves as Health Care Professionals uh certainly have a lot of room to improve um I have gotten uh more text than I would have expected this season asking from my you know med school classmates oh what should I do about what do you think I should do for the covid vaccine this year and I wrote back and I was like well what's the question you know well do you think I should get it so you know also thinking about reminding our friends our colleagues you know with the holidays coming up also we can all play a role every single one of us can play a role there okay I'm just gonna ask one or two last questions um Dr Kevin maybe to you and others just some of the other Q&A that have come in there's some questions about the covid-19 vaccine and you knowes it doesn't actually totally prevent illness like could you explain like does that have to do with incubation period why is that I'm sure that's a question we've all gotten hey I've gotten the vaccine but I still got covid so what's going on with that sure yeah happy to start and turn it over to others to to weigh in as well um I think you know one thing to emphasize is that even if it doesn't prevent you from getting infected it can help protect you against severe disease right you may have seen um the CDC flu campaign recently which is wild to mild right which is once again emphasizing that point these are great infographics and ads if you haven't seen them for example have like a Grizzy Bear is the Wild and then the mild is a little cute little teddy bear and it's just trying to relay that yes you can still get infected after some of these vaccines but once again it can help protect you against severe disease so your illness will be more mild um and just to highlight some data that's on the CDC website this is from last year 2023 to 24 but that those data did indicate that the that version of the covid-19 vaccine offered about 54 4% U protection against infection alone so that's just getting infected right so that's not the additional protection against hospitalization ICU death Etc and so and just to to further that point a little bit um you know the covid-19 vaccines for this year so the 2024 to 25 um versions were um updated to help protect against the variants that are circulating right and so we CDC FDA do anticipate that the current vaccines will help protect against the variants that are circulating now wonderful um I think that we have just a couple of minutes left so I just want to do a quick round robin of you know what's your last piece of advice again we are surrounded by our peers our clinician colleagues and just last piece of advice that you all might have for those who are listening and those who might be watching this webinar recorded afterwards so Dr Elizabeth let me start with you then we'll go to Holly Dr Sandra and then Dr Jen yeah I think I'll just you know hit home the every patient every visit every time so every time we have an encounter with our patients we should be asking you know have you received your vaccines this season um and then also leaning in I know we've already gotten some great tips from U my colleagues here on the on the call today about addressing the hesitancy but um not ever being judgmental and and leaning in and and having that conversation and finding common ground of saying you know you you know we have a relationship together and you know I care about you and your family and and kind of building from that and building from the trust that our patients have in all of us great Holly yeah I would I would Echo that with the building trust um nothing is more not nothing but very few things are more sacred than um the trust between patient and the health care provider and you have to be respectful and when they have concerns and worries we don't always know where it came from what their previous experience was how they were treat before they came and saw us so we do have to really dig deep sometimes and find out why they're hesitant and it might be an easy fix it may not but it might be an easy fix by restoring that trust treating someone respectfully and sharing your personal um expectations as well and what you've done for your family and yourself for vaccinations Dr Sandra so please don't underestimate the power a physician recommendation and adults and children who receive a recommendation from a health care provider to get vaccinated are more likely to get vaccinated so our recommendation is so important and it takes a village it takes all of us to get the job done so get it done get it done today get it done now great and Dr Jen I think the one thing that I didn't hear us talk about is making sure that it's easy for patients to get a vaccine and so sometimes we're unable to offer that at the moment in our office perhaps we ran out of stock perhaps that's a vaccine we don't manage to cover at this point and I think that one of the important things that we can do is know where patients can access these vaccines maybe it's your clinic maybe it's a health department maybe it's a pharmacy but there are lots of places where people can get them and a not just a strong recommendation to go get it but helping the patient make a plan about where and how they're going to get that done I think often closes the loop great and then my final word will be we ourselves need to make sure we get ourselves vaccinated as healthc Care Professionals so please make sure you have and then encourage your colleagues to do so um we really appreciate everyone's attendance day let me turn it back over to Betsy to close us out great thank you so much Dr Wong thank you to everyone who submitted questions and to all of you for joining us today thank you also to all of our speakers and subject matter experts who were on the line for joining us from CDC AMA Ana APA and dou AFP I hope everyone has a great day and a happy healthy holiday season