# Presentation: 771274

## National Influenza Vaccination Week (NIVW)

**Kristine Sheedy, PhD**
**National Center for Immunization and Respiratory **
**Diseases (proposed) **
**Office of Health Communication**
**February 5, 2007**

## NIVW: Summary

- November 27-Dec 3
- Inaugural season
- Annual event
- To help raise awareness of the importance of influenza vaccination and the importance of continuing vaccination throughout November and beyond.
- Partnerships key to NIVW planning and implementation

**Notes:**
To help raise awareness of the importance of influenza vaccination and the importance of continuing vaccinating throughout November and beyond, the United States Department of Health and Human Services (HHS), the Centers for Disease Control and Prevention (CDC), the National Influenza Vaccine Summit, and other partners and stakeholders will be announcing a National Influenza Vaccination Week (NIVW) from Monday, November 27th through Sunday, December 3rd, 2006. The key objective of this campaign is to promote influenza vaccination after Thanksgiving and through January and beyond. 

We recommended this be a "Week" rather than a day for a number of reasons, including: a) a week provides the many affected organizations- particularly vaccine providers- needed flexibility in terms of scheduling additional clinics or efforts; b) a single date will likely create scheduling problems for partner organizations, seemingly force a lot to happen on a single day, could (unnecessarily) foster long lines (and, in turn, discourage vaccination), provide too short a timeframe for fostering greater vaacine use (e.g., a week enables sustained efforts over many days) and can enable mass vaccinators to play a greater role (e.g., they may be able to continue to do so vaccinations in retail locations the week after Thanksgiving)

## Making it happen in less than 4 weeks.....

- Immediately following the HHS/CDC decision to hold NIVW, several calls were held with partners.
- NACCHO, AIM, ASTHO, the Influenza Vaccine Summit and other partners played a key role in defining the rationale for and purpose of NIVW.
- Partners developed letters of support
- A press briefing to announce NIVW was held November 13
- NIVW announcements also went out via MMWR, HAN, Summit newsletter, web, and other channels.

**Notes:**
Partners included the Summit, ASTHO, NACCHO, AIM, NPHIC, HHS regional offices, other HHS Op Divs, NFID,and others.

National Influenza Vaccination Week Partners:National Influenza Vaccine Summit American Academy of Family Physicians (374 KB)American Academy of Pediatrics American College of Physicians American Lung Association American Medical Association American Public Health Association Association of State and Territorial Health Officials National Association of County & City Health Officials National Foundation for Infectious Diseases 

## Making it happen in less than 4 weeks..... (cont.)

**Campaign materials were created and pitched**
**Television and radio PSAs, print ad, posters, op ed, NIVW web site**
**Meetings were held with 3 major networks in NYC.  Agreement secured from CBS to run PSAs during NIVW and beyond**
**Media buy plan developed**

## Making it happen in less than 4 weeks..... (cont.)

**A satellite media tour with Dr. Agwunobi was held Nov. 16**
**CDC created an on-line calendar of events**
**Federal, regional, and state and territorial NIVW events could be submitted and viewed.**
**http://www.cdc.gov/flu/nivw06activities**
**Communications to providers were distributed**
**“****Dear colleague” letter from Dr. Gerberding**
**Guidance for providers who would not have enough vaccine for NIVW**
**Outreach to business groups**

**Notes:**
Submissions from about 30 states 

## During NIVW....

- HHS press conference held Nov. 27
- Radio and television ads played in 96 markets, covering 67.44% of the U.S. population.
- Radio and TV ads resulted in a potential 155,773,400 audience impressions.
- A full-page black and white print ad ran in the November 28th issue of USA TODAY reaching a potential audience of 2.2 million readers.
- CDC spokespeople conducted English- and Spanish-language radio interviews in mainstream and ethnic media nationwide.
- Summit newsletter went out daily
- Increase in calls to the CDC hotline.

**Notes:**
Summit newsletters - Medical Professional Organizations were asked to Please disseminate widely to all of your members.  The messages included the Dear Colleague letter, guidance to providers, resources, success stories, and a thank you.

These just reflect our efforts.  We were quite impressed with the responses from the states and small private providers -- pediatricians, pharmacists and small community health clinics sending in their information about flu clinics -- extending hours and planning flu clinics for December, drive-in programs, and creativity in getting employees vaccinated. 

## Evaluating NIVW

- NIVW is aimed at changing how people think about the timing of influenza vaccination and will likely require multiple years to accomplish.
- Because the goal of NIVW is to change behavior (among providers and the public), we anticipate changes in awareness and understanding well in advance of actual behavior change.
- Evaluation measures for NIVW collected this year are most appropriately focused on awareness rather than attempting to measure changes in attitudes or behavior, both of which are unlikely to occur on a large scale until after awareness has been raised.
- Evaluation measures obtained this year are most appropriately used to develop a baseline for future NIVWs.

**Notes:**
Because the goal of NIVW is to change behavior (among providers and the public), we anticipate changes in awareness and understanding well in advance of actual behavior change, and plans for evaluating NIVW should be tailored around what is currently understood about the process for changing behavior.  For example, one widely accepted model for behavior change is the Stages of Change, which includes five stages:  precontemplation, contemplation, preparation, action, and maintenance.

## Evaluating NIVW (cont.)

**Evaluation plans include:**
**Surveys to evaluate awareness of NIVW and collect self-reported activities from providers and other sponsors**
**Surveys to assess awareness among the public**
**Surveys to obtain baseline estimates of annual vaccination (including identification of vaccination in December and later when possible).**

**Notes:**
B.  Proposed approach to evaluate AWARENESS/SELF REPORTED ACTIVITIES among providers and other “sponsors” 
Surveys of Immunization grantees, local health departments, colleges, private providers, and National Business Group on Health to assess awareness of NIVW, activities undertaken as part of NIVW, and suggestions for improving NIWV. Alan has a study of family practice and pediatricians in the field with Gallup looking at pediatric influenza vaccination issues.   Results expected late Feb.

C.  Proposed approach to evaluate AWARENESS among the public include
Questions about awareness are being added to a telephone survey of the adults is currently planned by ASPA for early January.  The focus of the survey is on pandemic influenza but will include a series of questions about seasonal influenza.  Should have topline results on February 9, 2007.  
D.  Proposed approach to obtaining BASELINE estimates of annual vaccination (including identification of late season vaccination when possible)  
National Immunization Survey, Adult Module—National sample of adults aged 18 and older to be conducted in quarter 2 of 2007; will provide self-reported information on influenza vaccination (ever had; had during 2006-07 season; and had during 2005-06 season); and reasons for vaccination or for not being vaccinated
National Health Interview—National sample, includes all ages; will provide self-reported information on month of influenza vaccination
National Immunization Survey—National and state-based samples of 6-23 month olds; will provide provider-verified receipt of influenza vaccination by date
State and Local Area Integrated Survey—National samples of children aged 0-17 years; will provide self-reported information on month of vaccination data 
National Surveillance System for Hospital Based Workers—Data about HCW vaccination from a small network of sentinel hospitals (n=22); will provide provider-verified information on receipt of influenza vaccination by date
Medicare claims data—Though these data typically underestimate vaccinations received, CDC will explore using these data to follow trends in late season vaccination among the Medicare population 

## Looking Ahead: NIVW 2007

**Planning has already begun**
**Needs to be a collective effort among partners**
**NIVW sessions will take place at the National Immunization Conference and annual Summit meeting.**
**Imagine what we can do with more than 4 weeks to prepare!**

## Thank You!

## NIVW Key Messages

- Influenza is a serious disease
- Vaccination is the best way to prevent influenza
- Vaccine supply is expected to be the highest ever and will continue to arrive on a rolling basis through December 2006
- Everyone wishing to avoid influenza should get vaccinated
- Providers should vaccinate every individual seeking it
- The time to get an influenza vaccine extends well into winter, through early 2007, when the influenza season typically peaks
- Flu vaccination of an individual helps protect that person and others

## Seasonal Influenza Calls and E-Mail to CDCINFO by Week