Preparing for Fall Vaccination Season

By Robert Moore, MD, MPH, MBA, Chief Medical Officer

“Vaccines are the tugboats of preventive health.”

– William Foege, MD, architect on the global strategy for eradication of smallpox

Now is a good time to have your teams meet to prepare for the coming fall vaccination season.  There are new vaccines, new recommendations and key populations to consider. You will want to be sure you know which vaccines to pre-purchase, which you might get from your County Health Department, and what your outreach strategies will be.

Even before the fall vaccines, in July through September, you will have a rush of kindergarteners and 7th graders needing to catch up on mandated vaccines in order to start school!

For young teens, while only an additional TDAP vaccine (beyond the K-12 admission vaccines) is required by the State, the CDC also recommends Meningococcal vaccination and a series of two HPV vaccinations for this age group. Be sure the medical assistants and your clinicians present this series as the expectation, noting that the HPV vaccine prevents cancer in both men and women. Begin the series early so it can be completed before the 13th birthday!

For infants between 6 months of age and 23 months of age, starting the primary influenza vaccination series as soon as possible in September (when it first becomes available) is worthwhile, since they need a second dose at least one month later to have full protection if they have not had the vaccine before. Parents, medical assistants, nurses and clinicians must reinforce that, unlike other age groups, infants are receiving the vaccine to develop primary immunity, and thus need two doses instead of one for older children and adults.

A new seasonal vaccine will be available this year against the Respiratory Syncytial Virus, but only for older adults (age 60 and over).  The RSV vaccine has just been approved by the FDA, and a CDC recommendation is likely forthcoming, so asking your vaccine supplier to let you know when it is available for ordering may help assure you a supply.  It is unlikely that County Health Departments will have much supply this first year.

For the fall COVID vaccine, last week the FDA recommended that vaccine manufacturers focus on a monovalent Omicron vaccination against subvariant XBB.1.5. The vaccine production infrastructure is gearing up to meet this need, with the mRNA vaccines having the fastest time from sequence to vaccine. Judging from last year, the vaccine will first be available in August or September 2023.  It is unclear which age groups will have the XBB.1.5 vaccine recommended. It could be all children age 6 months and older, or it could be a narrower recommendation. Since the vaccine will not be provided directly by the government, if you have capacity to store this vaccine in the primary care setting, consider pre-ordering some now.

Finally, keep in mind other recommended adult vaccinations! When ordering or recommending influenza and COVID vaccination, consider vaccination status for other adult vaccinations: TDAP booster status, Pneumococcal vaccination, Shingles vaccination, and Hepatitis B vaccination (see separate article on new recommendation for universal testing). If a patient requests one vaccine, take the time to talk about other recommended vaccines and get them at the same time!

Plan ahead! Talk to your health department and your local pharmacies!  Work together on educational campaigns!

Immunizations are one of the most valuable services offered by primary care. We must proudly offer our expertise to talk to our patients about how they can support their body’s immune system to fight future infections with early vaccination.