When patients ask you why they should get vaccinated for the seasonal flu, you’ll be glad you watched this webinar.

Short answer: It’s the most important flu shot of the century because it has the potential to stop the “twindemic” of seasonal flu and COVID-19.

At a September 15 webinar, Drs. Jon Temte and James Conway from the UW School of Medicine and Public Health presented information supported by research and illustrated by graphs that shows the undeniable benefit of getting the flu shot now and being vaccinated for COVID-19 when it becomes available.

Here are a few quick takeaways from their presentation:

• Australia is a bellwether for the severity of seasonal influenza in the northern hemisphere. This year, Australia saw the flu season peak early with far fewer cases than in past years and then fall and stay at zero, largely attributed to social distancing, masking, and hand washing.
• Influenza and SARS CoV-2 are expected to circulate at the same time. In this context, vaccination against influenza will be more important than ever to decrease the overall impact of respiratory illnesses by reducing influenza-associated hospitalization and deaths and reducing the burden on the health care system.
• SARS CoV-2 vaccine will initially be available in only limited doses. Dr. Conway shared that each state has been asked to develop a vaccine distribution plan to health systems and public health. A chart shared by Dr. Temte that shows how H1N1 vaccine distribution was prioritized in 2008:

Dr. Conway said in surveys where the public is asked if they will get the SARS Co-V2 vaccine, the negative responses are very similar the reasons given for not getting the seasonal flu shot:

• Concerns about side effects
• I will get the coronavirus from the vaccine
• Vaccines don’t work well
• Coronavirus outbreak is not as serious as some people say it

In response to a question from the audience, Temte said older patients should not wait to be vaccinated until later in the season because it is important to avoid crowding at vaccination sites.

“We want people to have flu vaccine on board before COVID-19 vaccine is administered because we don’t have a lot of information on co-administration of these vaccines,” according to Dr. Temte. However, Conway said for those in the clinical trials receiving the COViD-19 vaccine did not preclude being immunized for influenza, so there will be some information forthcoming.

The recording of the above presentation can be found in our member site, Online Community, under Education, Assembly Meeting Materials.

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Behavioral Health: Members Share Suicide Prevention Strategies

In a recent issue, Wisconsin Health News reported that Milwaukee County has seen an 80% increase in suicide attempt encounters compared to last year. From 2000-2017 the suicide rate rose 40%, which might now already be rising further due to the current pandemic.

September is Suicide Prevention Month and the Wisconsin Department of Health Services released a report in partnership with Prevent Suicide Wisconsin to address the concerning increase of suicides among Wisconsinites. The suicide prevention report highlighted four key strategies to help address this public health crisis:

1. Increase and Enhance Protective Factors
2. Increase Access to Care for At-Risk Populations
3. Implement Best Practices for Prevention in Health Care Systems
4. Improve Surveillance of Suicide and Evaluation of Prevention Programs

WCHQ members have been discussing their methods in addressing suicide ideation and the increased demand for mental health services among their communities, patients and staff. Examples of these methods include staff check-ins, such as weekly meetings and systemwide surveys and assessments on their mental health needs and childcare needs. To increase behavioral health service capacity, members are thinking creatively, such as decreasing appointment lengths slightly to allow for more patient visit timeslots. Primary care providers are encouraged to obtain waivers to prescribe Suboxone in an effort to expand on already-burdened Medication Assisted Treatment programs. Finally, using online mental health platforms, such as myStrength or SilverCloud, are good options to reinforce treatment provided to patients and to offer a broader net of behavioral health tools and resources accessible 24/7.

Many health systems and organizations are collating community-accessible resources on mental health.
These are useful not only for outreach purposes but also to strengthen any established mental health support offered within your health system.

• American Medical Association Caring for Our Caregivers During COVID-19
• Ascension Wisconsin mental health COVID-19 resources for employees, families, and leadership.
• UW Health COVID-19 Mental Health Resource Guide & Support and Support for Healthcare Providers
• WI Department of Health Services Resilient Wisconsin
• Project Recovery Helping WI Through a Pandemic

Adolescent and Child Health Assembly

On September 19, WCHQ hosted its second Adolescent and Child Health Learning Assembly, focused on the importance of routine vaccinations during the COVID-19 pandemic. L.J. Tan. MS, PhD, Chief Strategy Officer at Immunization Action Coalition (IAC), delivered the keynote address. In his presentation, “The Critical Importance of Improved Immunization Rates During COVID-19,” Dr. Tan shared a wide array of data demonstrating the importance of vaccines for adults and children and the national and statewide drops in rates for vaccinations at all stages of life. Dr. Tan also discussed the potential for a “twindemic” of COVID-19 and influenza during this year’s flu season if we do not improve vaccination rates.

Yolanda Wolff, MD, a pediatric specialist with Children’s Wisconsin, delivered a presentation titled “Maintaining Well-Child Visits through Telehealth and Immunization Clinics.” During her presentation, Dr. Wolff shared actions taken and lessons learned by Children’s Wisconsin as they transitioned to a virtual care delivery system for well-child visits at the outset of the pandemic. Their unique strategy of combining nurse-only visits for vaccinations and measurements with virtual visits to complete all other portions of the well-child visit allowed Children’s to reduce the backlog in appointments due to cancellations and rescheduling while maintaining vaccination rates to avoid a resurgence in other communicable diseases.

The final presentation was delivered by Alexandria Cull Weatherer, MPH, of the Wisconsin Cancer Collaborative. Her presentation, titled “The Importance of HPV Vaccination During COVID-19,” emphasized the need to continue vaccinating adolescents against HPV despite the increased use of telemedicine during the pandemic. Ms. Cull Weatherer shared information on the benefits of HPV vaccination for all children, the effectiveness of the vaccine, and existing guidance and strategies for HPV vaccination during the pandemic.

The recording of the above presentations can be found in our member site, Online Community, under Education, Assembly Meeting Materials.

Oral Health Collaborative

On September 21, WCHQ shared information on the Wisconsin Medical-Dental Integration Program with members of the Oral Health Collaborative and the Adolescent and Child Health Steering Team. Dana Fischer, MPH, CHES and Jenna Linden, RDH, CDHC, of the Children’s Health Alliance of Wisconsin explained how the pilot program is designed to embed a registered dental hygienist in primary care pediatric clinics. The goals of the project are to increase access to preventive dental care and reduce dental disease burden for young children and pregnant women.

The recommended age for a child’s first dental visit is one year, and yet children with Medicaid are not typically visiting a dentist until they reach the age of three or four. This poses a problem as children can develop caries at an early age. According to Wisconsin Head Start, by the age of three, 30% of children will have caries and by the age of five, that percentage increases to an alarming 50%. The Children’s Health Alliance of Wisconsin aims to improve the health outcomes of children by exposing them to dental care at earlier ages and in the primary health care setting which children frequent often. The American Academy of Pediatrics states that children visit a medical provider ten times between the ages of six months and five years.

The Wisconsin Medical-Dental Integration Program is based on research conducted by Dr. Patty Braun who is a pediatrician champion of these efforts for more than a decade. Between 2008-2011, Dr. Braun conducted a study to determine the feasibility of integrating a dental hygienist into the medical care team. Her conclusions were auspicious, demonstrating a 16% reduction in early childhood caries and a 28% reduction in untreated childhood caries.

The team at the Children’s Health Alliance of Wisconsin is actively recruiting health systems and clinics to participate in the Wisconsin Medical-Dental Integration Program. Preferred candidates have a medium to high Medicaid patient volume, at least three medical providers in one clinic, and have an oral health provider champion. If your health system or clinic is interested in learning more about this program, please contact Dana Fischer.

Sources available upon request, contact Jen Koberstein.

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As communicated in past newsletters, WCHQ is transitioning to a new data platform, that we have named, “Data Voyager.” While development and member data uploads are behind the original schedule, they are advancing at a pace that will allow the preview period to begin as planned for members whose data is ready, with results being added for the remaining members throughout the preview period.

The pandemic has caused delays in receiving refreshed data from all WCHQ members, so WCHQ is delaying the next updated reporting period to January 2021. WCHQ staff will be reviewing the measure results at that time and communicate the results in advance to data-reporting members.

Several early-adopting members were granted access to the Data Voyager User Acceptance Testing (UAT) environment where they explore and evaluate early copies of their measures. The feedback is very useful and has resulted in development fixes such as better qualification of patients by birthdate.

If you have questions related to data submission, contact Matt Gigot.

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