Category Archives: Oregon Immunization

General Immunization news that addresses Immunization efforts at a state-wide level.

A Linfield Nursing Student’s Perspective on working with the Oregon Immunization Program

by Judi Majors

After practicing bedside nursing for 30 years at the same hospital, I was given a unique and somewhat rare opportunity to intern in a public health rotation. At the Oregon Immunization Program under Jeanine Whitney’s guidance, I gained a newfound knowledge about vaccines and how vaccination impacts community, national and global health. This opportunity was truly a profound privilege. Two other Linfield College of Nursing students joined me in this enlightening adventure. We agreed that this experience changed us forever as nurses and citizens. The learning environment was incredibly detailed, supportive and encouraging. Jeanine’s feedback on required writing assignments furthered my understanding of vaccines, various cultural views of vaccination, health promotion and about building my cultural humility in working with vulnerable populations.

The required reading Jeanine assigned, including Vaccine (Allen, 2007), Vaccinated (Offit, 2007), the Pink Book and various authoritative websites, was eye-opening. Working in two pop-up vaccination clinics, writing a standing order update and benefiting from the knowledge of all Immunize Oregon staff, enabled the three of us to grow immeasurably. 

How did all three interns (with 52 combined years of nursing experience) know so little about the immense impact of vaccines on the health of populations and the security of our nation? I felt embarrassed. Jeanine reassured me that I was not alone in understanding the magnitude and value of vaccination.

As a nurse, this was significantly important for me to recognize. With the help of Jeanine Whitney, Carol Easter and Alison Alexander, I have had an experience that most nurses need and would be thankful for.

I return to work in the hospital with knowledge of the ALERT Immunization Information System which I plan to promote at my hospital, the knowledge that comes with a newfound responsibility to promote vaccination, and the discovered voice to advocate for increased focus on public health in the United States for the health and well-being of its citizens. The interns and I are indebted to the collaboration of Linfield College and Immunize Oregon in providing this clinical experience: thank you. 

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National Influenza Vaccination Week

 

National Influenza Vaccination Week (NIVW), scheduled for December 8-14, 2013, provides an opportunity to remind everyone 6 months and older that it is not too late to get a flu vaccine. NIVW is a national observance established in 2005 by the Centers for Disease Control and Prevention (CDC) to highlight the importance of continuing influenza vaccination after the holiday season into January and beyond.

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Flu vaccination coverage estimates from past years have shown that influenza vaccination activity drops quickly after the end of November. CDC and its partners want to remind you that even though the holiday season has arrived, it is not too late to get your flu vaccine.

As long as flu viruses are spreading and causing illness, vaccination can provide protection against the flu and should continue. Even unvaccinated people who have already gotten sick with one flu virus can still benefit from vaccination since the flu vaccine protects against three or four different flu viruses (depending on which flu vaccine you receive) expected to circulate each season.

The CDC has a National Influenza Vaccination Week website full of information and resources (including customizable posters and brochures) which can be found here.

Oregon Health Authority maintains an influenza resource located at http://flu.oregon.gov. It includes information for parents, providers, schools, businesses and health care workers.

 

Employment Opportunities

To share any employment opportunities, please email katherine.h.mcguiness@state.or.us

Nurse Manager/Care Coordinator

Sunset Pediatrics, a four physician pediatric clinic on Portland’s west side, is currently seeking a full time Nurse Manager/Care Coordinator.  Responsibilities include support, training and management of clinical staff, organization and optimization of new and special services, monitoring and reporting of quality measures, support of Clinic Administrator and Providers, and care coordination and maintenance of current Tier 3 Medical Home responsibilities.

The Nurse Manger performs all duties in a manner which promotes teamwork and continuity of care and practicesRequired skills and credentials to successfully perform Nurse Management duties include but are not limited to: Current BSN with 3-5 years experience, current CPR/PALS certification, excellent triage skills, strong verbal and organizational skills, and patient centered focus.  Preferred skills that would help in the Nurse Management role include but are not limited to: Pediatric experience, management experience, business background.

Salary: Negotiable

Fax Resume, with cover letter, to 503-291-1584 Attention: Jennifer

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Understanding the Personal Impact of a Vaccine Preventable Disease (Rubella and Congenital Rubella Syndrome)

by Jeanine Whitney

Growing up, my cousin Tim looked a lot different than the rest of the children in my family. Comparatively, he was boney and had really scary scars on his chest.  He was knock-kneed and had to wear glasses so thick it looked like they had Vicks® VapoRub® on them.  You could count his ribs, too! And he was always going into the hospital for something or other. 

Twenty some years later we would better understand why.  Tim was a CRS (congenital rubella syndrome) baby from the early 1950’s. His mom, Aunt Betty, had been exposed to rubella (three-day measles) during the first trimester of her pregnancy. All in all, Tim was one of the luckier ones.  He lived—but not without life-long problems.

Tim had multiple eye surgeries so he could see. Congenital cataracts are a common problem with CRS. Then he had open heart surgery, chest tubes and more knee surgeries than any of us wanted to count, the last one during his second year of college.

Did all these medical problems slow Tim down? Not really. He could ride a bicycle, skate board, snow ski and even water ski but he got tired faster than the rest of us so we waited for him to catch up. Tim was lucky. He lived, he could hear just fine, wasn’t blind, had a great mind and never developed diabetes.

Why is Tim’s story so important?  1950 was bad but 1964-19654 was worse with 12.5 million cases of rubella and 20,000 newborns with CRS. What about today? In countries where MMR (measles, mumps, and rubella) vaccine went by the wayside because they vaccinated only girls in 19891 and again in 19982 when most kids vaccines went by the wayside along with the Wakefield paper, those unvaccinated boys and girls are now in their child-bearing years. Rubella is alive and well.

Poland is a good example. Between January 2013 and April 2013 there were 21,283 cases of rubella (an average of 5.8 per 100,000 inhabitants), a 10-fold increase compared to the 2,224 cases in 2012. In some communities the rate range was 7.4—151.1 per 100,000 inhabitants. The male to female ratio was 10:1 with 15-19 year old males representing 57% of the cases.

During this time there were 2 cases of CRS reported whereas there were only 4 cases total reported in the 9 years between 2003 and 2012.

In Romania in 2011-2012, rubella cases totaled 20,772 with 11 cases of CRS.

          While this is more prevalent in Europe, it is a concern to those of us living in the United States. The US total rubella cases through September 2013 are 6 and all of them are imports.

          If you want to look at US measles, 98% of 163 cases are imports from Africa, Pakistan, Sudan, Turkey, Germany, UK, Poland, Italy, Azerbaijan, Belgium, Israel, Republic of Georgia, Ukraine, Europe, Mexico, India, Indonesia, Korea, Thailand, and China.

          Rubella and CRS may only be a plane trip away. It maybe someone else who is doing the travelling or you could come back a silent carrier.  

          If you know someone who may become pregnant, ask about their MMR vaccine or titer. It really is important. And before you leave home? Get your travel vaccines up to date.

 

 

1, 3In 1989, Poland started to administer monovalent rubella vaccine to 13 year-old girls but not boys.

2, 3In 1998 Wakefield’s paper caused a reduction in MMR vaccination in both boys and girls.

3 Paradowska-Stankiewicz, I., Czarkowski, M.P., Derrough, T., & Stefanoff, P.(2013) Ongoing outbreak of rubella among young male adults in Poland: Increased risk of congenital rubella infections. Eurosurveillance, Vol 18, Issue 21.  Retrieved from  http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20485

4Rubella. In: Epidemiology and Prevention of Vaccine Preventable Diseases (“Pink Book”). Atkinson W, Hamborsky J, Wolfe S, eds.12th ed Second Printing. Washington, DC: Public Health Foundation, 2012:275-290

Available at http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/rubella.pdf

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Immunize Oregon Coalition Meeting- You are Invited!

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Immunize Oregon Coalition Meeting- All Are Invited!

This will be a great opportunity to learn the basics about vaccine preventable diseases and the importance of immunizations, as well as to connect with other partners doing health work in the state.

October 29th

11:45am-2pm

800 NE Oregon St, Portland OR 97232

Room 1A

Lunch Provided: Please RSVP by October 24 to katherine.h.mcguiness@state.or.us

Call-In Information: 888-431-3632

4901986

 

At this meeting:

Learn about Immunize Oregon, a new lifespan Immunization coalition formed by  the merging of the Oregon Adult Immunization Coalition and Oregon Partnership Immunization Coalition.

Help Immunize Oregon select a LOGO!

A special screening of Invisible Threat, a documentary produced by high school students  examining why parents decide not to vaccinate their children, and the consequences that can follow. 

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Immunization Public Provider Conference and Flu Summit Wrap Up

This year, the Public Provider Conference, hosted by the Oregon Immunization Program, and the Oregon Flu Summit, hosted by Immunize Oregon, were held back to back at the Ambridge Center in Portland on September 24th and 25th. Here is a quick summary of what was covered at the events.

 

Public Provider Conference 2013

The 2013 Public Provider Immunization Conference was held on September 24th at the Ambridge Event Center.  More than 120 attended and were provided updates on 10 separate grants currently being completed at the state level as well as ongoing programs.   Topics included ALERTIIS, the Billable Vaccine Project and Immunization Programs and Oregon’s Transforming Health System.  Adolescent Immunization data and reminder recall was also shared with teen vaccination rates being the focus over the next few years.  The Research, Data, and Surveillance Team provided an exciting opportunity to discuss reports and statistics in the session Data Dreams to explore what reports best provide support to county programs and direction.   The increasing number of non-medical exemptions was also discussed as well as implementation on new legislation requiring parents to be informed about the vaccine-preventable diseases before submitting a non-medical exemption for one or more vaccines for their child’s attendance at schools/children’s facilities.

The conference also provided an opportunity for county and other public provider staff to extend their best wishes for the future to Lorraine Duncan who recently retired as Program Manager of the Immunization Program after 33 years of service.  Thank you to all who attended and made the conference a success.

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Flu Summit

With event registration reaching 325 people this year, we knew that there was a big need in Oregon for knowledge about the flu. The theme for the 2013 Flu Summit was “Reaching New Heights for Prevention”, which guided an expanded topic selection for this year’s event. Dr Paul Cieslak, the medical director for the Oregon Immunization Program, and Dr Erin Kennedy, a medical epidemiologist from the CDC gave updates and clarifications on changes to flu vaccine presentations, an epidemiological look at flu last year state and nationwide, and some thoughts about what is in store for this season. Steve Robison, an epidemiologist with the Oregon Immunization Program spoke about using Oregon’s immunization registry, ALERT IIS, to do near real time tracking of flu. Health care policy was addressed in a panel discussion, helping to demystify the process of how policy change happens and how to become an advocate for change in your community. The Vaccines for Children program and ALERT IIS both had breakout sessions, which were a great opportunity for participants to learn more about changes that are happening. Dr James Mason, director of Providence Health Service’s Culturally Competent Care Giving spoke about cultural beliefs around health and illness, and gave the audience tips on how to navigate cultural differences and still provide the best care to patients possible. The day ended on an inspirational note, with a panel consisting of a long term care facility and a hospital, both with incredibly high employee flu vaccine rates talking about how they have been so successful in maintaining those levels of protection for staff and patients. They shared about why they thought health care worker flu vaccine rates were so important, and how they inspired change in their organizations to work towards the goal of flu prevention. Thank you to everyone who participated, spoke, and attended!

 

Job Postings

To submit employment opportunities to be posted on ImmiNews, please email katherine.h.mcguiness@state.or.us

Oregon Health Authority – Immunization Health Educator  

Lane County- Public Health Manager

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2013 Immunize Oregon Awardees

by Katherine McGuiness, MPH, MSW

Earlier this year, Immunize Oregon, the statewide, lifespan immunization coalition, put out a call for nominations to honor immunization champions in five categories. We were thrilled to receive so many nominations highlighting the fantastic work of so many people, clinics, and organizations around the state. Winners were honored at the Oregon Flu Summit on September 25th.

 

Individual Immunization Leadership

An individual, who has demonstrated a commitment to increasing individual or community immunization levels through innovative approaches.

Winner: Wendy Jackson, Clinical Nurse Manager at Central Oregon Pediatric Associates (COPA)

Wendy Jackson has been instrumental in leading COPA through multiple immunization projects, specifically in relation to ALERT IIS and influenza vaccine. She led a project to report the organization’s administered pediatric immunizations and histories to ALERT IIS, and to facilitate Real Time Interface between the organization’s EHR and ALERT IIS.  Ms. Jackson has also worked to improve pediatric influenza vaccination rates in Central Oregon, by streamlining internal processes, workflows and resources so that COPA can provide better flu vaccine access and availability to their patients. COPA’s flu shots administered rates has improved 40% between 2008-2012. She has also made great strides in tackling employee flu vaccination rates. Last year 97% of COPA’s employees were vaccinated for the flu.

 

Communication and Promotion

An organization that leverages resources to deliver immunization messages through the use of no-cost, limited budget, or media partnership opportunities (i.e. public service announcements, opinion/editorial pieces or series of news articles, newsletters, columns, notice boards, community calendars, websites, social media, or messages included with regular mailings).

Winner: Becky Sherman, Ashland Immunization Team

As chair of the Ashland Immunization Team, Becky has worked to determine the best way to communicate immunization messages to the parents of Ashland, an area with extremely low children’s immunization rates. She has partnered with the Oregon Health Authority, local public health, local physicians, researchers, parents and others to explore creative ways to reach out to the Ashland community in a proactive but sensitive manner. Understanding the area and the concerns of the parents in Ashland, she has worked to create a website, brochures, and toolkits that are culturally specific to her community.

 

Local Public Health Partner

A local health department, immunization coalition, school nurse, school-based health center, tribal health clinic, community health center, rural health center or migrant health center that has demonstrated an outstanding commitment to increasing immunization access and awareness in their community through the use of culturally responsive communications.

Winner: Kelly Jensen/Malheur County Health Department

As tough times have hit Oregon communities, and local health departments have struggled to keep their doors open, Malheur County has managed to improve and diversify their immunization program. Kelly Jensen, Malheur County Health Department’s Immunization coordinator has become an essential immunization resource in her community, pulling it together to improve immunization services in that region. In 2012, she formed the Treasure Valley Immunization Coalition, comprised of healthcare providers, the local hospital, pharmacies, pharmaceutical representatives and the health department, working towards training and improved immunization infrastructure.

 

Innovative Partnership

A collaboration of two or more organizations to successfully promote immunization activities.

Winner: OCHIN and its Clinic Users

OCHIN and its clinic users have been invaluable partners to ALERT IIS since 2006. When ALERT converted to its new system in 2010, OCHIN was the first data exchange partner to begin submitting batch electronic data to the new registry. OCHIN has been working on continuous improvement in regards to ALERT IIS use. None of the technical advances could have taken place without the knowledgeable contributions of OCHIN clinic users. Currently, 122 clinics send data to ALERT IIS via OCHIN’s Epic interface. They have their eyes on data quality and completeness day in and day out, working collaboratively with both OCHIN and the ALERT IIS team to ensure data integrity and high performance.

 

Policy Champion (new category)*

An individual or organization that champions policy change that improves immunization infrastructure and/or public health in relation to vaccine preventable disease.

Winner: Jay Rosenbloom, Pediatrician

Jay Rosenbloom’s passion is working on how best to address vaccine hesitant parents and communities. Realizing how high Oregon’s exemption rate was for school children, he decided to act. He partnered with the Oregon Pediatric Society (OPS) to make sure parents had a better understanding of the importance of immunizations before exempting their children from vaccines for school.  Senate Bill 132A, championed by Dr. Rosenbloom and OPS passed this legislative session, and  as of March 1, 2014 will require informed consent for parents for parents before they exempt their children from vaccines, either from a medical provider or online education.

 

Visionary

Recognizes an individual who has served as a “visionary” to Immunize Oregon. A candidate must have demonstrated: Focused leadership during times of change through a keen understanding of the importance of immunizations in preventing disease, and achieving local, state, national and global health; A history of organizing, educating, and inspiring colleagues and community partners to achieve strategic immunization goals; Commitments to health equity and the collaborative leadership process.

Winner: Lorraine Duncan, Oregon Immunization Program

Lorraine Duncan has managed the Oregon Immunization Program (OIP) for 33 years, working to strengthen immunization services, in both private and public settings. Under Lorraine’s tenure, OIP grew from 5 to over 60 employees, developed an immunization registry, became part of the VFC program, started coalitions and advisory groups, worked to eliminate racial/ethnic immunization health disparities, and made partnerships a theme throughout every part of the program. Lorraine strengthened current law that ensured children in schools and childcare centers were vaccinated, which has led to higher immunization rates, and continuing partnerships at the state and local levels. The Oregon Immunization Program is so thankful for her service, and we will miss her as her new journey of retirement begins.

 

* Immunize Oregon did not put out a call for nominations for this award category this year, but after receiving a nomination for this individual in another category, we realized this was an awards category we needed.

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Reducing the Burden of HPV with a new Oregon Senate Bill

by Lorraine Duncan

In an effort to reduce the burden of human papilloma virus (HPV)-related cancers, Senate Bill 722A directs the Oregon Health Authority (OHA) to prepare an HPV addendum to the Oregon Comprehensive Cancer Plan. The Comprehensive Cancer Plan is Oregon’s blueprint for cancer prevention and control, and by adding a strong immunization component to it, OHA will increase its usefulness and effectiveness. This bill passed and was signed into law on June 6, 2013, by Governor Kitzhaber.

To prepare for making legislative recommendations by September of next year, the HPV addendum will assess the following:

  • Existing disease prevention or surveillance policies, measures and programs;
  • Public and health care provider awareness;
  • Gaps in knowledge; and
  • Opportunities to improve all of the above.

According to the Oregon State Cancer Registry, in 2010 there were a total of 746 Oregonians diagnosed with HPV-associated cancers and 172 deaths. The Oregon Comprehensive Cancer Control Plan was created by a statewide coalition and is updated every five years. It identifies prevention strategies for the leading causes of cancer, including lung, colorectal and breast cancers. Internal and external partners report on progress made for each cancer priority area, including prevention and early detection, access to quality cancer treatment and cancer disparities.

An internal workgroup has been formed at OHA, and they have had one meeting and made beginning assignments. Stay tuned for more news to come.

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