What are you doing with adult pneumococcal vaccinations moving forward?

[StewardshipDude]

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Herd immunity from PCV7 in adults in not in dispute. Perhaps it's a bit early to infer the same results from PCV13 but it seems that if similar, the potential benefits of vaccinating adults with PCV13 isn't as compelling as it once looked.

On the other hand, catching up on back issues of JAMA and re-read this:
http://jama.jamanetwork.com/article.aspx?articleid=1105020

Confusing. What's your take? Even you, Stavi.

 

[StewardshipDude]

P4P and the potential loss of up to 2% of inpatient payments from CMS creates some opportunities for us to play the key role in building strategies to improve immunization rates and improve revenue. It shouldn't be left to infection control nurses only.

 

[KARM12]

The new specs manual for CMS effective for 1/2013 not longer gives preference for PPSV23.

 

[StewardshipDude]

The new specs manual for CMS effective for 1/2013 not longer gives preference for PPSV23.

We saw that. It's not clear though. If we have an HIV+ 19 yr old vaccine naive who shows up it looks like we vaccinate with PCV13 first and then 8 weeks later PPSV23. It the same person shows up already having been given PPSV23 we then have to wait 12 months to give PCV13, right? What if our nurses give PPSV23 first in the naive - we will get dinged on our quality measures or is CMS's pending change of IMM measures just making the language permissive of either vaccine, regardless of ACIP and MMWR?