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The Indiana Immunization Coalition exists to promote childhood immunization and raise community awareness about immu

The Indiana Immunization Coalition exists to promote childhood immunization and raise community awareness about immunization issues.

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The Indiana Immunization Coalition exists to promote childhood immunization and raise community awareness about immu

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  1. The Indiana Immunization Coalition exists to promote childhood immunization and raise community awareness about immunization issues.

  2. The Indiana Immunization Coalition is a volunteer organization which represents over 165 agencies from many different disciplines that are concerned about the immunization of children.

  3. Why Coalitions?The health coalition movement is an emerging trend in the healthcare community. As society moves toward a greater focus on health and wellbeing for all citizens, the immunization coalition model will be replicated across many issues and ultimately will be the catalyst for changing the way communities look at health.Immunization Coalition Sustainability Project

  4. Building Community Partners“It is no longer just about the public health system. It includes private health care systems, private industry, and the nonprofit community. Coalitions bridge those systems and build a healthier community.”Immunization Coalition Sustainability Project

  5. GOALS • Promote and support statewide immunization registry development and use. • Develop marketing/awareness strategies for immunization issues. • Provide statewide leadership to create opportunity for participation, education and collaboration on immunization issues.

  6. IIC Beginnings • Support the statewide immunization registry. • Share immunization information with organizations who are concerned with the welfare of children. • Developed “Best Practices” brochure for providers. • Actively supported, monitored and influenced policy regarding immunization bills in the state and federal legislature. • Filmed and distributed an immunization awareness Public Service Announcement featuring former First Lady Judy O’Bannon.

  7. CHIRP Every Child By Two Registry Mentoring Grant

  8. Shots For Tots

  9. The Indiana Immunization Coalition Appreciation Awards recognize efforts in advocacy, registry, education and collaboration

  10. Child health data shows a significant reduction in well baby checks and immunization visits after a child turns one year of age.

  11. Immunize Hoosier Children Indiana’s Immunization Challenge • 22% of Hoosier children don’t receive recommended immunizations by age 2 • Indiana ranks 39th nationally in immunization for 2-year-olds Proposed Solution • Allocate $11M to expand the child vaccination program • Saves $25 in additional health expense for every additional $1 spent on childhood immunizations Source: ISDH The Governor’s Plan for a Healthier Indiana

  12. www.inimcoalition.org

  13. Why Adolescent Immunization? • Many adolescents are under-immunized, putting their health and their futures at risk. • Many states have implemented “catch-up” requirements for Hep B, MMR#2, Dtap. • New vaccines are being developed many specifically for adolescents.

  14. Adolescent Immunization “The good news is we can now prevent so many diseases. The bad news is it’s gotten more complicated.” Dr. Anne Schuchat, U.S. Centers for Disease Control and Prevention, Immunization Programs.

  15. Diseases Prevented by Vaccination of Children and Adolescents

  16. Vaccine Recommendations by Age Group, 2003 and 2007 † Assumes 2 doses of influenza vaccine for 4 year olds †† Includes HPV, 3 doses for females only. For males, 4 diseases and 2 doses

  17. Adolescent Immunization Barriers • Few well child visits-approximately 60% receive primary care from a pediatrician or family physician. Others have different provider or no provider at all. • No measurement or accountability system at state or local level • May need to consider other points of access such as schools Vaccination Success and Stresses, Walter Orenstein, MD

  18. 78 82 78 82 79 85 NH 86 81 MA 89 83 82 86 RI 87 83 81 CT 88 86 86 NJ 83 82 68 80 DE 86 79 83 71 81 87 MD 80 77 81 82 78 DC 83 79 82 82 79 72 82 84 80 82 84 85 75 75 73 89 Estimated Vaccination Coverage with the 4:3:1:3:3* Series, by Coverage Level and State 2004- National Coverage = 81% VT 85 81  90% 80-89% 70-79%  69% *4+DTP, 3+Polio, 1+measles-containing vaccine, 3+Hib, 3+HepB

  19. How is Your County Doing? • Healthy People 2010 Goal • Immunization rate of 90%

  20. VACCINATE BEFORE YOU GRADUATE INDIANA 2004 ENVIRONMENT • The state of Indiana passed new legislation requiring 9th and 12th graders receive the Hepatitis B vaccine. • A new recommendation for meningococcal immunization was forecasted for the coming year as well as a new vaccine. • Pertussis was being added to tetanus and strongly recommended for adolescents. • HPV wasn’t on the radar.

  21. VACCINATE BEFORE YOU GRADUATE INDIANA HEPATITIS B VACCINE LAW • Law passed in 2004, effective 6/05-6/08 • Affects 9th and 12th graders • No school record audit or reporting to ISDH required • No suspension of students if don’t meet the requirement • An opportunity to promote Hepatitis B, other vaccines for adolescents.

  22. VACCINATE BEFORE YOU GRADUATE INDIANA Adolescent Subcommittee The committee’s first meeting was in the spring of 2004. The committee is comprised of representatives from Indiana Immunization Coalition, Indiana State Department of Health, Indiana Department of Education, Kiwanis, School Nurse Association, Sanofi Pasteur, GlaxoSmithKline, Managed Health Centers and the Meningitis Foundation.

  23. VACCINATE BEFORE YOU GRADUATE INDIANA Promoting Immunization through community networks is a proven means to build trust and acceptance of vaccines. Why Invest in Communication for Immunization? Silvia Waisbaord and Heidi J. Larson

  24. VACCINATE BEFORE YOU GRADUATE INDIANA MAP IT Mobilize individuals and organizations Assess the areas of great need Plan your approach, start with a vision Implement you plan with action steps Track your progress Healthy People 2010

  25. VACCINATE BEFORE YOU GRADUATE INDIANA PROGRAMS • Rhode Island developed a marketing campaign as well as school based clinics. • Virginia developed a marketing campaign, tool kit and held a national satellite conference. • Arizona used at risk students to develop an award winning marketing campaign.

  26. VACCINATE BEFORE YOU GRADUATE INDIANA PLAN The vision of the Vaccinate Before You Graduate program is to develop a statewide initiative that increases adolescent immunization coverage through education, collaboration and vaccination.

  27. VACCINATE BEFORE YOU GRADUATE INDIANA IMPLEMENTATION The committee created and implemented a model program to share with others throughout the state. The program originally focused on Meningococcal, Tetanus, Hepatitis B, Varicella and Measles Mumps and Rubella.

  28. VACCINATE BEFORE YOU GRADUATE INDIANA PILOT PROGRAMS • Hammond • Vanderburgh County • Vigo County

  29. VACCINATE BEFORE YOU GRADUATE INDIANA TRACKING PROGRESS OVER TIME

  30. VACCINATE BEFORE YOU GRADUATE INDIANA 2006 HEALTH DEPARTMENT SURVEY • 66% of Health Departments participated • 50% had started a Hepatitis B program for adolescents • 10% had started a VBYG program • 62% were collaborating with schools • 84% focused the program on high schoolers

  31. VACCINATE BEFORE YOU GRADUATE INDIANA 2007 HEALTH DEPARTMENT SURVEY • 35% of Health Departments participated • 63% had started a Hepatitis B program for adolescents • 16% had started a VBYG program • 78% were collaborating with schools • 88% focused the program on high schoolers

  32. VACCINATE BEFORE YOU GRADUATE INDIANA 2006 HEALTH DEPARTMENT SURVEY • School nurses did the paperwork • 61% used postcards for notification • 38% conducted special clinics hours • 20% conducted school clinics • 10% were using VBYG materials

  33. VACCINATE BEFORE YOU GRADUATE INDIANA 2007 HEALTH DEPARTMENT SURVEY • School nurses did the paperwork • 84% used postcards for notification • 22% conducted special clinics hours • 19% conducted school clinics • 16% were using VBYG materials

  34. VACCINATE BEFORE YOU GRADUATE INDIANA 2006 HEALTH DEPARTMENT SURVEY • Difficult to complete due to vaccine shortages • Difficult to offer all vaccines at school based clinics • Difficulty with staffing issues to do more • Great collaboration with school nurses

  35. VACCINATE BEFORE YOU GRADUATE INDIANA 2007 HEALTH DEPARTMENT SURVEY • Increase in offering other vaccines from 2% to 34% • Reported reduction in school based clinics due to poor turn out. • Collaboration with schools consists of schools sending out Hepatitis B letter and health departments immunizing children. • Staffing issues make it difficult to do more.

  36. VACCINATE BEFORE YOU GRADUATE INDIANA 2007 SCHOOL NURSE SURVEY • Sent out required Hepatitis B letter. • Eager for immunization information. • Reported little contact with local health departments. • Liked school based clinics.

  37. VACCINATE BEFORE YOU GRADUATE INDIANA UNEXPECTED OUTCOMES • Vaccine availability-Healthy Indiana Plan • School nurse module for CHIRP

  38. VACCINATE BEFORE YOU GRADUATE INDIANA “The campaign’s success relies in part on vaccine supply.” Dr. Anne Schuchat, U.S. Centers for Disease Control and Prevention, Immunization Programs.

  39. VFC and Section 317 Vaccine Funding to Immunization Programs

  40. VACCINATE BEFORE YOU GRADUATE INDIANA VACCINE AVAILABILITY January 2007--The Governor renewed his legislative proposal to increase Indiana’s tobacco excise fees and introducing the Healthy Indiana Plan. The Plan would provide smoking cessation programs, fund the children's vaccine gap and provide insurance coverage for adults.

  41. VACCINATE BEFORE YOU GRADUATE INDIANA VACCINE AVAILABILITY May 2007—ISDH became one of the first pilot site for VMBIP (Vaccine Management Business Improvement Project). August 2007-- ISDH evaluating vaccine ordering system to ensure timely delivery of vaccines.

  42. VACCINATE BEFORE YOU GRADUATE INDIANA We may need to consider other points of access such as schools. Vaccination Success and Stresses, Walter Orenstein, MD

  43. School Facts • 22% of Indiana’s Citizens are 5 – 19 yrs. old • Kindergarten to Grade 12 • Public school • 1,045,702 • Private school • 109,124 • Home school • 23,455 *2006-2007 Department of Education

  44. School Facts • School vaccination laws • Vary from state to state • Indiana allows for medical and religious exemptions • Failure to vaccinate results in exclusion from school

  45. Documentation in Schools • Parents must provide documentation for first time enterers • Kindergarten • First Grade • Sixth Grade • Transfer to a new school • Becomes part of official student school record • Reported to state DOH and CDC

  46. Documentation in Schools • Paper • Electronic School Health Records • Free-standing • “Home Grown” • Part of a larger student record management system • Subject to Federal Education Reform Privacy Act (FERPA) regulations • Few commonly used applications

  47. History of Schools and Registry • Unreliable source of data • Use of non-clinical staff for data entry • Transfer from paper records • Legibility of record • No knowledge of the immunization schedule • Didn’t question suspicious dates • Didn’t question illegible dates • No supervision by nursing • Limited computer skills & Internet access

  48. School Immunization Reports • Annual reporting requirements • Reportable to state department of health and / or the Department of Education • Due by mid-November annually • School funding tied to immunization coverage rates • Public health involved in this activity in some states

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