Telemedicine can help limit the time spent in the emergency department (ED) and help hospitals with demand surges, according to a new study published in 

The coronavirus disease 2019 (COVID-19) pandemic has limited doctors’ offices and hospital visits to help ensure patient and care provider safety. Telemedicine can help bridge the gap rather than diminish the quality of care, according to the study. Additionally, overcrowding in EDs are a common problem in general, which can be costly for hospitals and impact patient experience.

Investigators looked at ED visits in New York from 2010 to 2014, comparing visits that utilized telemedicine versus those that did not.

Investigators found that telemedicine significantly reduces average length of stay. According to the study, this finding is partially driven by flexible resource allocation. Using telemedicine during ED surges can also reduce hospital stays and reduce patient wait times.

The majority (76%), of United States hospitals are already using telemedicine technologies.

"The current pandemic has shown hospitals the great promise of telemedicine application and hopefully the unexpected enrollment of such policies, alongside this research, can help get the process underway to help more health care facilities utilize this technology in [Eds] and elsewhere," study author Susan Lu, PhD said in a prepared statement.

"Policymakers can play a role as well by reducing regulatory barriers that inhibit more expansive use of telemedicine and by creating incentives that encourage hospitals to more broadly adopt telemedicine in emergency rooms,” said Lu.

Adopting telemedicine during ED surges would not increase costs, study authors say, nor would it increase the expense of care quality.

Utilizing telemedicine in the ER can reduce wait times and patient length of stay [News Release] October 16, 2020; West Lafayette, Indiana. 

https://www.eurekalert.org/pub_releases/2020-10/ifor-uti101620.php

Articles

Investigators found that using telemedicine can improve patient experience. 

Study: Telemedicine Can Reduce Emergency Department Backlog, Wait Times

Halloween will likely look different this year as the coronavirus disease 2019 (COVID-19) pandemic persists throughout the United States. Many families look forward to Halloween festivities, and there are a variety of creative and safe ways to celebrate while reducing the spread of COVID-19.

This is a great time for health care professionals to educate the public and remind everyone about the importance of masks, physical distancing (staying at least 6 feet apart), and frequent hand washing. Individuals should not let their guard down during Halloween, as it is critical to prevent the spread of COVID-19. It is also an important time to remind the community that everyone’s actions have a direct impact on the health of others.

Both the CDC and American Academy of Pediatrics (AAP) have issued guidance on Halloween activities, and health and safety measures.

 “The decisions we make on this 1 day can have a ripple effect on our family members.We can find safe ways to celebrate and create magical memories,” said Shelly Vaziri Flais, MD, FAAP, pediatrician and AAP spokesperson in a prepares statement.

Evidence demonstrates that even small family gatherings can lead to COVID-19 spread when appropriate safety measures are not followed.

Hosting a virtual costume party is a great way to stay connected with family and friends.2 Pumpkin carving, decorating, and a Halloween movie night with members of the same household can be fun for all ages. Creating a Halloween themed scavenger hunt by hiding treats around the house is also sure to be a big hit.

Outdoor activities with family and friends that are not in the same household should involve physical distancing, mask wearing, and frequent hand washing.

 Drive through events are being advertised on social media as a safe way to experience Halloween without getting out of the car, and may even have curbside treats and pumpkins. Attending an outdoor costume parade can be a fun way to celebrate Halloween, as long as all health and safety measures are followed.

 If visiting a pumpkin patch, it’s important to wash hands or use hand sanitizer with at least 60% alcohol after touching surfaces and pumpkins.

 Crowds should be avoided, and individuals should not attend indoor events such as haunted houses, as these can increase the spread of COVID-19.

Individuals should avoid traditional trick-or-treating, and residents should sit outdoors wearing face coverings if they would like to hand out individually packaged treats.

 Families should bring hand sanitizer and use frequently while trick-or-treating, and wash their hands after returning home. All individuals aged 2 years and older should wear adequate face coverings, as costume masks are not sufficient against COVID-19 transmission, if trick-or-treating.

It also is important to offer non-candy options for children with food allergies, and in doing so, households can participate in the Teal Pumpkin Project.

 All families should wipe down treat bags and keep candy in quarantine for a few days as an extra precaution.

CDC. Coronavirus disease 2019 (COVID-19): Trick or treating and other Halloween activities. Updated October 9, 2020. Accessed October 14, 2020. 

https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/holidays/halloween.html

AAP. American Academy of Pediatrics offers tips for a safe Halloween during pandemic. Published September 22, 2020. Accessed October 14, 2020. 

https://services.aap.org/en/news-room/news-releases/health--safety-tips/american-academy-of-pediatrics-offers-tips-for-a-safe-halloween-during-pandemic/

Schwartz NG, Moorman AC, Makaretz A, et al. Adolescent with COVID-19 as the Source of an Outbreak at a 3-Week Family Gathering — Four States, June–July 2020. 

Many families look forward to Halloween festivities, and there are a variety of creative and safe ways to celebrate while reducing the spread of COVID-19. 

Halloween Activity Health Tips During the COVID-19 Pandemic

Every year on October 12, the observance of World Arthritis Day calls global attention to the complex, multifaceted disease that causes both physical and emotional impacts, yet is still called the ‘invisible disease.’1

Many people with arthritis are more vulnerable to the coronavirus disease 2019 (COVID-19) due to their age or a compromised immune system. Taking action and spreading awareness about the seriousness of arthritis can help make health care more accessible and affordable for chronic diseases and finding a cure.

There are multiple ways that the public can advocate for the cause and spread the word about World Arthritis Day. For example, the Arthritis Foundation is asking the public to take part in the 

 study and sharing the results with policymakers, medical experts, and product manufacturers to bring about major changes.

Additionally, on October 14, 2020, there is an opportunity to be an advocate for World Arthritis Day by participating in the roundtable discussion, “Policy Prescription: Improving Pain Management Through Research, Innovation, & Access” which will talk about the challenges arthritis patients face and potential solutions to improve care and outcomes.

In recognition of World Arthritis Day, PainBloc24 is matching 

s to the Arthritis Foundation for up to $25,000. The donation match is occurring for 1 day.

World Arthritis Day 2020. Arthritis Foundation. Published October 5, 2020. Accessed October 12, 2020. 

http://blog.arthritis.org/living-with-arthritis/world-arthritis-day-2020/?_ga=2.44939812.187298419.1602514455-1418080035.1602514455&_gac=1.255058650.1602514455.cjwkcajw_y_8brbieiwa5mcbjvltulvviyid2zduptck5gtzqoo0oojj445b_bcvxjbmurj9fpefhxoc6z0qavd_bwe

Every year on October 12, the observance of World Arthritis Day calls global attention to the complex, multifaceted disease that causes both physical and emotional impacts, yet is still called the ‘invisible disease.

Bringing Attention to the ‘Invisible Disease’ on World Arthritis Day 2020

New community-focused pharmacy and health care initiatives are being implemented by Walgreens in Chicago, Illinois, to address health disparities and improve outcomes beginning in underserved neighborhoods on the South Side.

“Improving the health and well-being of the communities we serve guides everything we do, and we know there is great need, as well as opportunity, to assist the patients we serve on their journey to better health,” said John Standley, Walgreens president, in a press release. “By learning more about the particular health needs in these areas and tailoring our pharmacy services to help address them, we can continue to make an impact as part of our commitment to Chicago, and with pharmacists our customers know and trust.”

Walgreens is working to expand access to affordable care and educational outreach to further support the city of Chicago’s health equity objectives, according to the press release.

Further, Walgreens has started to bring health service offerings to Chatham on the South Side of the city, including the following initiatives:

, where pharmacists are prioritizing high-touch consultations for those living with diabetes to personalize solutions, address any barriers to taking medications and making recommendations for health screenings and immunizations.

, where pharmacists are conducting outreach to parents and guardians of children with asthma to provide education on the importance and proper use of asthma medications, review adverse effects, discuss asthma triggers, and provide action plans in collaboration with health care providers as needed.

, with flu shots provided at no cost through initiatives with health insurers, the Illinois Department of Public Health, local community groups and churches in Little Village, Chatham, Gresham, Englewood, Bronzeville, Austin, and Roseland.

, sponsored by the First Ladies Health Initiative, working with African American church leaders and pastors’ wives to provide thousands of free health screenings, including blood pressure, blood glucose, HIV screenings, and immunizations.

where Walgreens is supporting the American Heart Association’s efforts to eliminate health disparities and the life expectancy gap between Chicago neighborhoods.

through the expansion of the Walgreens Prescription Savings Club, which provides savings up to 80% off of more than 8000 medicines to members.

In addition to these new initiatives, Walgreens has extended its offering of free prescription delivery for 1- to 2-day deliveries through the end of 2020.

Walgreens addressing health disparities in Chicago’s Underserved Communities with New Pharmacy and Healthcare Initiatives. Walgreens Newsroom. 

https://news.walgreens.com/covid-19/press-releases-1/walgreens-addressing-health-disparities-in-chicagos-underserved-communities-with-new-pharmacy-and-healthcare-initiatives.htm?view_id=8541

. Published October 7, 2020. Accessed October 9, 2020.

Walgreens Addressing Health Disparities in Underserved Chicago Communities

Data science can be effectively used to predict patient outcomes for areas such as medication utilization and readmission rates to hospitals, according to a session on applying data science at the DHX Virtual conference. These predictions can help the users of data science tools to support the delivery of optimal patient care.

Data science uses the scientific method, processes, algorithms, and systems to extract applicable knowledge from structural and unstructured data, explained speaker Dalton Fabian, PharmD, RPh, a data science analyst at UnityPoint Health, during the session.

The field is comprised of different disciplines in order to tap into their skillsets, including math and statistics, business knowledge, and computer science, according to Fabian. Each of these disciplines then fits in uniquely to the function of data science in pharmacy.

For the use of math and statistics, data science analysts apply these skills when using data from the past to predict the future, such as the likelihood of whether someone will be readmitted to the hospital within 30 days of discharge.

Business knowledge, on the other hand, is used by data science analysts to communicate with nurses regarding the tools that the analysts have made. This communication helps analysts confirm that the nurses have a full understanding of the tools they are using, according to Fabian.

“As pharmacists, we understand the intricacies of health care, like how to read lab descriptions and how to interpret lab values using those types of skills in our data work,” Fabian explained.

Additionally, Fabian noted that data scientists use computer science skills when writing sequel queries to obtain or analyze data implementing models and programming languages, such as R and Python, as well as visualizing data with platforms such as tableau.

David Berkowitz, PharmD, an Omnicell One field strategist and director of the Omnicell fellowships in data analytics and automation research, said during the session that obtaining data is always the first step to commencing work as a data science analyst.

“First, you need data,” Berkowitz said. “The standard nomenclature is ETL—extract, transform, and load. And that’s getting data from your source system, whether it would be an electronic health record, laboratory system, IOT device, blood pressure cuff, etc.”

The next step is to transform these data into a format that is usable, such as Epic, which is written using Massachusetts General Hospital Utility Multi-Programming System (MUMPS). MUMPS, a programming code that was developed in the late 1960s, is a language that is effective for fast operations, which allows users to click a lab result and find the necessary information quickly.

“That’s why when you build, say, a workbench report, it’ll sort of crap out after looking back 14 days, because that type of search is not meant for querying, doing research, and doing data analysis—it’s meant for operations,” Berkowitz said.

By moving the data and encoding it into a different format, which is usually structured query language (SQL) in health care, data science analysts are able to store the data. The databases available to for storage are generally SQL, No-SQL, and cloud storage; however, not all providers use these databases when storing data.

“There are still a lot of folks in health care, probably actually a majority, that store their data on premises, or you’ll hear ‘on prem,’ which can make it a little harder to do data science because you have to sort of, when doing a specific analysis, enrich data with different sources,” Berkowitz said. “It’s harder to do that on prem in real time because of connections. So, cloud first is my motto.”

At Omnicell, Berkowitz noted that his team uses almost exclusively SQL. However, other employees at Omnicell will code using Python, R, or Scala, although the language used is often dependent on the specific problem the analyst is trying to solve.

For data visualization, analysts commonly use Qlik, Power-BI, Tableau, or R-Studio in order to communicate data more effectively and support business intelligence and predictions, Berkowitz explained.

At UnityPoint Health, Fabian noted that they have used these different elements of ETL to create a tool called Population Health, which is primarily used by care managers to enroll patients in care management services. This tool can help to lower costs for high-risk patients by decreasing utilization and increasing the frequency of patients’ meetings with care managers. This helps to catch issues before they become critical and require a hospital visit.

“What we did, as a data science team, is develop a machine learning model that predicts the likelihood that a patient is going to go to the hospital or the ED in the next 12 months, and that’s how we determine high risk,” Fabian said.

Fabian noted that this tool helps to allow care managers to spend more time taking care of patients rather than needing to focus on administrative tasks that they were doing previously to figure out whom to enroll.

Another tool created by UnityPoint Health is the Readmission Heat Map, which is used to decrease 30-day admission rates. This tool allows for the prediction of whether patients will readmit to the hospital within 30 days of discharge, down to the day.

“In this tool, we’re taking all of the data we have access to in Epic, like disease states, medication, and the fact that people are in the hospital, and pairing that with a predictive model to help those nurses make better decisions about the care that a patient is going to need once they get out of the hospital,” Fabian said. “Anything over a 20% likelihood, and nurses will take heed and intervene on behalf of those patients.”

Berkowitz noted that by applying these same types of data science tools to medication utilization, analysts are able to help pharmacists visualize data from their pharmacy in a chart. For example, this could be applied to visualizing the effects of the pandemic on medication utilization at a pharmacy.

“I took a look at vaccination rates since January 2020 to see how COVID-19 has affected vaccination rates,” Berkowitz said. “Basically, it went down to nothing. This kind of tells me that either folks weren’t stepping on nails or they weren’t getting care and going to their pharmacies.”

Fabian D, Berkowitz D. Applying Data Science. Presented at: DHX Virtual 2020; October 2, 2020; virtual. cpha.com/event/dhx-virtual/. Accessed October 2, 2020.

Data science can help to predict patient outcomes for areas such as medication utilization and readmission rates to hospitals. 

Data Science Can Predict Patient Outcomes to Optimize Care

New research suggests that infants born in the fall may have a higher risk for allergic diseases such as eczema, food allergies, asthma, and hay fever.

Previous research has found that food allergies are on the rise, with approximately 2 children in each classroom now allergic to at least 1 food. Researchers at National Jewish Health aimed to discover the reason behind this increase, which showed that many allergic conditions likely start with dry, cracked skin, eventually leading to a chain reaction of allergic diseases known as the atopic march.

“We looked at every child treated in our clinic, and those born in the fall were much more likely to experience all of the conditions associated with the atopic march, said lead author Jessica Hui, MD, in a press release. “Now we are learning more about why that is and we strongly believe it stems from the bacteria on the skin and how they affect the skin barrier.”

According to the study authors, the atopic march typically begins in infancy with eczema and leads to food allergies, asthma, and hay fever in later childhood. Children with eczema often have high levels of the bacteria staph aureus on their skin, which weakens the skin’s ability to keep our allergens and pathogens, according to a press release.

“When food particles are able to penetrate the skin rather than being digested, the body sees them as foreign and creates antibodies against them, which causes the child to become allergic,” Hui said.

To further their research, the investigators are now conducting a clinical trial to examine a wide variety of factors that may contribute to this weakened skin barrier in infants. The study is enrolling pregnant women and following their children into early childhood to consider everything from environmental factors to genetics to medications taken and products used in the home.

“We think if we can intervene at a very young age, even right after the baby’s out of the womb, then potentially that’s a way for us to try to stop the development of this atopic march,” Hui concluded in the press release.

Potential solutions could include sealing the skin barriers of babies with eczema using wet wraps and lotions and introducing allergenic food early in life for children at risk of allergies.




Study Finds Fall Babies at Higher Risk of Lifetime of Allergic Diseases [news release]. National Jewish Health; September 9, 2020. 

http://njhealth.multimedia-newsroom.com/index.php/2020/09/09/study-finds-fall-babies-at-higher-risk-of-lifetime-of-allergic-diseases/

Researchers believe the progression of allergies begins with eczema in infancy before progressing to food allergies, asthma, and hay fever later in childhood.


Study: Babies Born in Fall at Higher Risk for Allergic Diseases

Two phase 3 studies showed an investigational 15-valent pneumococcal conjugate vaccine (V114, Merck) was well-tolerated among patients and met the primary immunogenicity objectives.

The phase 3 Pneu-age study assessed the vaccine’s efficacy in healthy adults aged 50 years or older. The results showed that the vaccine was not inferior to the currently available 13-valent pneumococcal conjugate vaccine (PCV13), according to the researchers.

In this study, the new 15-valent vaccine was found to be as successful in targeting the 13 serotypes that are currently targeted in the 13-valent version, with the V114 vaccine being superior in targeting serotypes 22F and 33F. This study also demonstrated the 15-valent vaccine was superior in targeting serotype 3, which is known to be a leading cause of invasive pneumococcal disease globally.

In the Pneu-true study, the researchers found V114 successfully demonstrated equivalent immune response across all 15 serotypes in healthy adults aged 50 years or older. In both studies, the researchers found that V114 was not only well-tolerated among patients, but the safety profile of the vaccine was comparable with the current PCV13 and consistent with the results of previous studies that assessed V114.

Merck plans to present these results and any additional phase 3 data from its clinical program to the public, allowing the data to form the basis of global regulatory licensure applications before the end of 2020.

“Diseases caused by serotypes not covered by the currently available pneumococcal conjugate vaccine are increasing worldwide and can vary by country or region. Additionally, we continue to see pneumococcal disease caused by serotypes included in the existing pneumococcal vaccines,” said Roy Baynes, MD, PhD, senior vice president and head of global clinical development, chief medical officer, Merck Research Laboratories, in a press release.

The pneumococcal serotypes that are not included in the current 13-valent pneumococcal conjugate vaccine, such as 22F and 33F, have been found to be associated with invasive pneumococcal disease throughout the country. These 2 serotypes, 22F and 33F, specifically cause 13% of the invasive pneumococcal disease observed in adults aged 65 years and older in the United States.

Additionally, serotype 3, which is targeted in V114, remains a leading cause of invasive pneumococcal disease in adults and children, despite the current 13-valent version in use also targeting this serotype. In total, 15% of invasive pneumococcal disease among adults aged 65 years and older is still caused by serotype 3 in the United States.

“These phase 3 data demonstrated that V114 generated a robust immune response to all 15 serotypes included in the vaccine and reinforce the potential for this investigational vaccine to help protect adults against pneumococcal disease,” Baynes said.

Baynes noted that additional research into pneumococcal disease prevention is necessary in order to target those serotypes that remain a risk factor for certain populations.

Merck Announces Positive Topline Results from Two Phase 3 Adult Studies Evaluating V114, Merck’s Investigational 15-valent Pneumococcal Conjugate Vaccine, Including Pivotal Trial. Kenilworth, NJ: Merck; September 9, 2020. merck.com/news/merck-announces-positive-topline-results-from-two-phase-3-adult-studies-evaluating-v114-mercks-investigational-15-valent-pneumococcal-conjugate-vaccine-including-pivotal-trial/. Accessed September 11, 2020.

Two phase 3 studies showed an investigational 15-valent pneumococcal conjugate vaccine (V114, Merck) was well-tolerated among patients and met the primary immunogenicity objectives. 

Positive Results Announced From Phase 3 Adult Studies Evaluating 15-valent Pneumococcal Conjugate Vaccine

Contemporary Clinic spoke with Gretchen McNally, nurse practitioner of hematology at Arthur G. James Cancer Hospital, about substance use disorder in oncology patients and addiction stigma.

With her immense background in substance use and abuse, McNally started to notice patients using cocaine, alcohol, and other substances in her own experience and the poor patient outcomes rooting from it. 

This made her determined to do something to help these patients, as every encounter with a health care provider is an opportunity to improve outcomes for people with addiction, according to McNally.

McNally also discussed how nurse practitioners can support patient care during COVID-19, how to further stop the stigma surrounding addiction, and what she hopes to see for the future of nurse practitioners in the oncology landscape.

Videos

Substance Use and Addiction Stigma in Oncology Patients

The National Association of Pediatric Nurse Practitioners (NAPNAP) is hosting a TeamPeds Town Hall event, titled “COVID-19 Update and Vaccine Development,” to discuss what health care professionals should expect related to vaccine development and distribution.

“This event is an excellent and timely opportunity for health care providers, parents, caregivers and other stakeholders to break through the noise to hear the most up-to-date, evidence-based information regarding COVID-19 vaccine development and distribution from an expert pediatric nurse leader,” said NAPNAP President Jessica Peck, DNP, APRN, CPNP-PC, CNE, CNL, FAANP in a press release.

The virtual event will be hosted on Wednesday, Sept. 23 at 8 pm ET. Infectious disease and immunology expert Patsy Stinchfield, MSN, CPNP, CIC, will discuss the virus, immune response nuances, what types of platforms are being considered and how the high need global vaccine may be fairly distributed.

Stinchfield is a widely recognized specialist in vaccine-preventable diseases, having served as the first nurse voting member of the CDC’s Advisory Committee on Immunization Practices (ACIP) where she continues as a liaison representing the National Association of Pediatric Nurse Practitioners. She is a long-time member of the CDC’s ACIP Influenza Working Group, the Pediatric Schedule group and Combination Vaccine working group.

The event is available for free to both members and non-members of NAPNAP and media are encouraged to attend. Participants can RSVP by clicking here: 

https://fs12.formsite.com/NAPNAPCE/dff7s1ea4w/index.html?1599583766634

NAPNAP to host town hall on COVID-19 vaccine. NAPNAP; New York, NY: September 9, 2020 [email].

NAPNAP to Host Town Hall on COVID-19 Vaccine

Dr. Reddy’s Laboratories has launched methylphenidate hydrochloride extended-release tablets USP 18 mg, 27 mg, 36 mg, and 54 mg. The generic product is a therapeutic equivalent of Janssen’s Concerta® extended-release tablets, 18 mg, 27 mg, 36 mg, and 54 mg, according to Dr. Reddy's.



Methylphenidate hydrochloride extended-release tablets are indicated for the treatment of attention deficit hyperactivity disorder (ADHD) in children aged 6 years and older, adolescents, and adults up to age 65 years.



Adverse reactions of methylphenidate hydrochloride extended-release tablets include decreased appetite, headache, dry mouth, nausea, insomnia, anxiety, dizziness, weight decreased, irritability, and hyperhidrosis.

Dr. Reddy’s Laboratories announces the launch of methylphenidate hydrochloride extended-release tablets USP in the US market [news release]. Hyderabad, India & Princeton, NJ; September 3, 2020: BusinessWire. 

https://www.businesswire.com/news/home/20200903005324/en

Vermes K. Mylan Launches Generic Concerta and Zovia in the US Market. 

https://www.pharmacytimes.com/news/mylan-launches-generic-concerta-and-zovia-in-the-us-market

 Published December 29, 2016. Accessed September 8, 2020.

Methylphenidate hydrochloride extended-release tablets are indicated for the treatment of ADHD.

New Generic Methylphenidate Hydrochloride Tablets Available on the Market

Contemporary Clinic spoke with Kelli Garber, lead nurse practitioner for school-based health and the center for telehealth at the Medical University of South Carolina and NAPNAP member, about the growth of telehealth and what health care professionals and nurse practitioners should consider when using telehealth.

Garber has worked with telehealth for the past 6 years, and she has seen such an incredible change in a short period of time in this field. In light of the COVID-19 pandemic, Garber has seen dramatic changes for providers, since these providers had no other choice than to utilize this tool. 

Garber also discussed what other health care professionals and nurse practitioners should consider when using telehealth, how telehealth benefits patients, and what she hopes to see in the future for telehealth and pediatric nurse practitioners. 

The Growth of Telehealth for Health Care Professionals

With flu season approaching and continuing concerns about the coronavirus disease 2019 (COVID-19) pandemic, understanding which demographics are more likely to receive immunizations is vital. New research from the University of California at San Francisco suggests that age, insurance status, and having a personal physician are all important determinants.

According to the investigators, only 1 in 3 US adults received the flu vaccine in 2018, a statistic that could have major implications for the 2020-2021 flu season. Keeping flu-related hospitalizations as low as possible is especially important this year, as the COVID-19 pandemic threatens to overwhelm health systems.

In the study, researchers evaluated self-reported flu vaccination rates from 2018. They included data from the 2018-2019 season, which showed 61,000 deaths, and the 2018-2019 season, which showed 34,200 deaths. The data were recorded in the Behavioral Risk Factor Surveillance System, which includes more than 400,000 adults in the United States.

Perhaps most notably, the study authors found that none of the subgroups exceeded the minimum vaccination rates for herd immunity.

“To achieve herd immunity, we would need to reach about an 80% vaccination rate, but no subgroup in our study exceeded 60%,” said senior author R. Adams Dudley, MD, MBA, in a press release. “While social distancing, mask-wearing, and staying away from crowds will mitigate the spread of the flu, a dangerous type of the flu—such as the Spanish flu of 1918—could result in more than 61,000 fatalities.”

Age, insurance status, and having a personal physician were all important factors in whether an individual received their flu shot. Specifically, 22.6% of those aged 18 to 24 years received the vaccine, compared with 59.3% of those over 75 years of age.

Among patients without insurance, just 16.1% were vaccinated compared to 41.6% of those with insurance, and just 19.4% of patients without a personal physician were vaccinated compared to 43.6% with a physician.

Having a chronic condition was also linked to higher rates of immunization. Just 31.6% of those without a chronic condition were vaccinated, compared to 52.7% of those with 4 or more chronic conditions.

Variations among income groups were smaller, however. Approximately 33.9% of those with a household income of less than $15,000 were vaccinated, compared to 41.8% of those with an income of more than $50,000. Variations were also seen between states, with the lowest vaccination rates in Texas (26.4%) and the highest rates in Washington, DC (44.2%).

Finally, the researchers found lower rates among Black and Hispanic patients (33.9% and 28.9%, respectively), and among men (36.7%). White and Asian patients had rates of 41.5% and 38.3%, respectively, whereas women had a 41.6% vaccination rate.

In order to increase vaccination rates for all subgroups, the researchers recommended both short- and long-term interventions.

“We need a concerted public health campaign that includes public health officials, health care providers, and local communities, and reaches those groups most at risk for not getting vaccinated,” said first author Brandon Yan, a third-year medical student, in a press release. “And we need a proactive primary care outreach strategy to address patient concerns and provide information on how and where to get vaccinated.”

Long-term goals may be more difficult to achieve but are no less important, Yan said. They include making the vaccines more accessible and making them free of charge for those who are uninsured.

“The ongoing pandemic also raises the issue of whether the flu vaccine and the future COVID-19 vaccine should be mandated,” Yan said. “While a federal mandate may be difficult politically, private organizations like colleges and employers could make attendance and employment contingent on getting up-to-date with vaccines.”

COVID-19 Vaccines Are Moving Fast, But Will Americans Agree to Get Them? [news release]. University of California at San Francisco; August 26, 2020. 

https://www.ucsf.edu/news/2020/08/418296/covid-19-vaccines-are-moving-fast-will-americans-agree-get-them

Age, insurance status, and having a primary care provider are all important determinants, but short- and long-term interventions are necessary to increase vaccination rates.

Study: Rate of Flu Immunizations Could Parallel COVID-19 Vaccine Acceptance

Contemporary Clinic spoke with Lukia Beverly, pediatric nurse practitioner and co-chair of NAPNAP’s Immunization Special Interest Group, about National Immunization Awareness Month.

Beverly has seen the stigma around immunizations change in recent years, with a lot of help from the growth of social media and technology.

According to Beverly, parents are still hesitant to bring their children into their health care provider’s offices due to the fear of COVID-19 and the uncertainty surrounding the virus. However, she is still starting to see an increase in rates of the public getting their immunizations.

Beverly also discussed how HCPs can engage families to maintain CDC immunization schedules during the pandemic, how to handle parents’ concerns about immunization visits, and what she hopes to see for the future of pediatric nurse practitioners in regard to immunizations.

Contemporary Clinic spoke with Lukia Beverly, pediatric nurse practitioner and co-chair of NAPNAP’s Immunization Special Interest Group, about National Immunization Awareness Month. 

Nurse Practitioners and National Immunization Awareness Month 

People who received at least 1 flu vaccination are 17% less likely to develop Alzheimer disease over the course of their life, according to a new study by the University of Texas Health Sciences Center at Houston (UTHealth).

There are around 5.8 million people in the United States living with Alzheimer disease. Currently, there is no known treatment. Because of this, it is important to find ways of reducing the risk of Alzheimer disease.

The study was composed of 310,000 electronic health records collected through the Cerner Health Facts database, which is composed of over 600 hospitals and clinicals. The study authors hypothesized that the flu vaccine may introduce proteins needed to train the body to fight off the disease.

The study found that more frequent flu vaccinations and receiving them younger in age were associated with an even lower risk of developing Alzheimer disease. More research is still needed in order to determine how and why the flu vaccine works to prevent the condition.

"One of our theories of how the flu vaccine may work is that some of the proteins in the flu virus may train the body's immune response to better protect against [Alzheimer] disease…Providing people with a flu vaccine may be a safe way to introduce those proteins that could help prepare the body to fight off the disease. Additional studies in large clinical trials are needed to explore whether the flu shot could serve as a valid public health strategy in the fight against this disease,” said Albert Amran, the study’s first author and fourth-year medical student at McGovern Medical School at UTHealth, in a prepared statement.

Flu vaccine may reduce risk of Alzheimer's disease, new study shows [news Release]. Houston, TX; July 27, 2020: EurekAlert!. Accessed August 28, 2020

Flu vaccination may introduce proteins used by the body to learn how to fight Alzheimer disease later on. 

Study Shows Flu Vaccine May Reduce Risk of Alzheimer Disease

The FDA has approved cysteamine ophthalmic solution 0.37% (Cystadrops, Recordati Rare Diseases, Inc.) for the treatment of patients living with cystinosis. The solution is the first FDA-approved cysteamine eye drop formulation that reduces corneal crystals with dosing 4 times a day, according to Andrea Recordati, CEO of Recordati Rare Diseases.

Cystinosis is a rare genetic condition present from birth. The condition causes the build-up of cystine crystals throughout the body, which causes widespread tissue and organ damage, and significantly impacts the eyes. Patients living with cystinosis often have sensitivity to light, eye discomfort and pain. Recent developments in treatment have led to increased life expectancies of those living with the disease.

In a phase 1/2a open label, controlled, randomized study across multiple centers, 15 patients were given cysteamine ophthalmic solution 0.37%. Eight participants also were part of an adaptive dose-responsive clinical trial. Corneal cystine density was assessed using 

The study found that patients receiving cysteamine ophthalmic solution 0.37% saw a 40% reduction in IVCM scores across all corneal layers 90 days after the baseline. Those in the adaptive dose-response clinical trial saw a 30% decrease in IVCM score, which was maintained through the 5-year study period.

“People living with cystinosis and their caregivers have to manage multiple medications every day. To reduce their daily burden, Recordati worked to develop a new viscous eye drop formulation for treating corneal cystine crystals,” said Recordati, in a prepared statement.

Common adverse effects associated with cysteamine ophthalmic solution was stinging, blurred vision, eye irritation, and eye redness. It is applied 4 times daily as a drop during waking hours and can be stored for up to 7 days at room temperature after opening.

U.S. FDA Approves CYSTADROPS® (Cysteamine Ophthalmic Solution) 0.37%, A New Practical Treatment Option for the Ocular Manifestations of Cystinosis (Press release) White Oak, MD, August 28, 2020 EurekAlert! Accessed August 28, 2020

Drops of cysteamine ophthalmic solution are applied 4 times a day.

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