Category Archives: Oregon Immunization

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

Nurses Notes

Back to School: Tips on Simultaneous Vaccination and Updates to the School Vaccine Schedule

by David Glassman, RN, MPH

If you have not done so already, it’s time to begin preparing your clinics for back to school immunizations. Check inventories and supplies and order early. Review the Oregon Immunization Program website  for up-to-date immunization to help ensure your practice is ready and contact information should you have queries.

There are a few changes to the schedule for the 2013-2014 school year. Immunization with Tdap has been expanded, and applies to students entering grades 7 to 12. Children attending kindergarten through grade 5 will need to have completed the2 dose Hepatitis A series.

Also related to back to school vaccinations is the importance of an internal clinic policy of simultaneous vaccination.  This is when more than one immunization is administered during the same clinic visit. Administering DTap in one arm or leg and IPV in another arm or leg during the same visit is an example of simultaneous vaccination.  Available data illustrates that “simultaneous vaccination with multiple vaccines has no adverse effect on the normal childhood immune system (CDC).” Both the Advisory Committee on Immunization Practices and the American Academy of Pediatrics recommend simultaneous administration of all routine childhood vaccines when appropriate.

Providing a child with several immunizations during the same visit offers two practical advantages. First, children should be immunized as quickly as possible to confer protection during the vulnerable early months of their lives. Second, giving several immunizations at the same time means fewer clinic visits. This may be less traumatic for the child and save parents both time and money.

When our patients present for immunizations, consider providing all the required vaccine at the same visit with the knowledge that it is safe, practical, and best practice.

School’s out…for the time being.

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Health Map Vaccine Finder Needs You

Are you an immunizing facility? Health Map Vaccine Finder is looking to partner with you!

Flu season is just around the corner, and now is the time for immunization providers to populate the online HealthMap Vaccine Finder with data on vaccine services. Last year, the free, online tool helped direct over 500,000 users to vaccine providers in their area. Please encourage providers to take advantage of this free opportunity to promote their vaccination services.  This year, HealthMap Vaccine Finder is asking for information on 7 kinds of influenza vaccines (trivalent, quadrivalent, high dose, intradermal, cell culture-based, recombinant, and nasal spray) and 10 other adult vaccines (hepatitis A, hepatitis B, HPV, MMR, Td, Tdap, meningococcal, pneumococcal, varicella, zoster).  Providers who participated last year can log in to their account at vaccine.healthmap.org/admin and update their information by following the directions on the Help tab.  New providers must first register for an account at vaccine.healthmap.org/admin/signup. Once you receive your password and login, you may then upload the required information to your account.  Please direct any questions to vaccine@healthmap.org.

 

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Data Pokes: (Re)Introducing- Kathy Scott!

 

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Please welcome Kathy Scott as the new Research, Surveillance, and Data manager for the Oregon Immunization Program (OIP).  Many of you may already know Kathy from her work this past year as the coordinator for the Adult Immunization Special Project.  She received her doctorate in Public Health far too many years ago and, after a brief stint in academia, plunged naively into the wacky world of public health practice.  She was first employed as an epidemiologist at the local level in California and Oregon and then moved on to the Oregon Health Authority.   Kathy took a break from government employment between 2009 and 2013 to work as a contractor on public health and preparedness projects.  In her new position, she will supervise a team of epidemiologists, research analysts, Strategic National Stockpile staff, and a CDC fellow.  A priority of hers is to help OIP provide local health departments with meaningful data.  Kathy is the mother of two college-age daughters, and she lives in Tualatin with her husband of 22 years, Deane.

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New Staff at OIP

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Lydia Emer is OIP’s new section manager

Oregon Immunization Program (OIP) is excited to welcome Lydia Emer back to the family as the new section manager to replace Lorraine Duncan, who is retiring. Lydia started working for the Public Health Division (PHD) in 2000 as an administrative assistant for OIP. Since then, she has worked in a variety of different positions and departments including fiscal analyst in both Maternal and Child Health and OIP. Most recently, she served as PHD’s performance management and quality improvement manager.

Lydia is excited to be back in OIP and to be closer to service delivery and the community. Originally from Portsmouth, Great Britain, Lydia moved to the U.S. after college. She enjoys spending time with her family and her pets and working in her vegetable garden. Please join us in welcoming Lydia back into the immunization family.

Lorraine is staying on as a temp until September 30th to assist in Lydia’s transition.

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Yuliya Goldman joins OIP as a CDC Public Health Associate for one year

Yuliya Goldman will spend the next year with OIP as part of the CDC’s Public Health Associate Program (PHAP). PHAP is a two-year fellowship that provides recent college graduates with a varied public health experience by placing associates at county, state or tribal health agencies. Yuliya just finished her first year of PHAP working at Public Health Division’s Health Security, Preparedness and Response Program. There she focused on Crisis Emergency Risk Communications developing communication plans, conducting media analysis, and contributing to website communications.

Yuliya is excited to begin her second year of PHAP as part of OIP, where she will be working on a variety of projects including developing materials to comply with SB132, the new law that requires parents to receive vaccine safety information before signing a non-medical exemption to immunization.

Yuliya grew up in St. Paul, Minnesota and has spent the past year in Portland. In her spare time, she enjoys exploring Oregon’s hiking trails and playing tennis when the rain allows.

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Alert on ALERT: All Pharmacists to use ALERT IIS

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Pharmacists play an increasingly large role in immunizing Oregonians. People aged 11 years through the lifespan can be immunized by their pharmacists against diseases such as pertussis, shingles, and influenza.

Oregon’s online ALERT Immunization Information System (ALERT IIS) is an important tool for pharmacists and all vaccine providers. Most immunizations that are given in Oregon are stored in the system. As a result, the ALERT IIS provides authorized users access to millions of patient vaccination histories.

Many pharmacists, however, don’t take advantage of some very helpful ALERT IIS tools for looking up patient histories and forecasting needed vaccinations. By using the ALERT IIS, pharmacist can avoid immunizing patients unnecessarily with vaccines they’ve already received and also find out what vaccines patients need that day, and in the future. Pharmacy techs and other staff (and anyone who is an authorized ALERT user) can also access these tools.

The Oregon Board of Pharmacy and the Oregon Immunization Program (OIP) have worked together to include the use of these ALERT IIS functions in the Pharmacy Protocols. The effective date for this protocol change is no later than January 1, 2014, although pharmacies are encouraged to begin using the ALERT IIS as soon as possible.

The new language that appears in each protocol is as follows:
Effective no later than January 1, 2014, prior to administering vaccine, pharmacy personnel will look up each patient in the ALERT Immunization Information System (IIS) to determine the patient’s vaccine history and to forecast vaccines needed.

Exceptions:
• This is not required when administering only influenza vaccines, but will continue to be recommended to help increase pneumococcal vaccine rates.
• This is not required when the pharmacy/pharmacist conducts a remote vaccine clinic, but will continue to be recommended when remote connectivity is available.

The revised protocols are available here.

OIP’s ALERT IIS staff have begun working with some pharmacy chains to get pharmacists and staff enrolled and trained to access ALERT IIS. One pharmacy chain is also pilot testing a bidirectional query interface between their Electronic Health Record (EHR) and ALERT IIS; this may be an additional option other pharmacies could explore for requesting and submitting immunization information. For more information on how you and your staff can connect to ALERT, please contact Jenne McKibben at jenne.mckibben@state.or.us.

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Planning for the worst: Emergency preparedness at its best

By Erin Corrigan

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Over three days in May, 2013, the Oregon Immunization Program participated in an exercise in emergency preparedness called PACESetter. It began in Atlanta and reached all the way up to Washington State, involving federal, state, tribal, county, city and private agencies. We were presented with the simulated scenario that bioterrorism and other attacks were made against citizens in five Oregon counties as well as Clark County in southern Washington. The intent was to respond to these simulated attacks exactly as we would in real life and to test our ability to share information not only across jurisdictions in Oregon but also across state lines with Washington.

In response, the Centers for Disease Control and Prevention (CDC) shipped medical supplies that we received at Oregon’s Receipt, Stage and Storage (RSS) area. Our team helped unpack and redistribute the supplies to Oregon’s impacted counties. We also activated our Agency Operations Center (AOC), which acts as the command center where planning, operations and logistics such as requests for federally funded medical supplies are coordinated and documented.

The RSS area works as a well-oiled machine with staff efficiently breaking down large pallets of material, including items from our Strategic National Stockpile (SNS), into smaller lots to be distributed where they’re needed. The AOC, on the other hand, is more like carefully controlled chaos with information coming in constantly that changes the scenario and the required response. In addition, the exercise planners always throw in unexpected events or additional threats that change the game to make sure participants are nimble and able to switch gears as needed, which is exactly what would be likely to happen in a real attack.

This exercise was a full-scale exercise (FSE), meaning that we used all aspects of the state and local agencies’ planning and response resources, from immunization program staff to emergency management staff to medical response teams, state partners and even the governor, who had to declare a state of emergency (a fake one, of course). We are required by our CDC federal emergency preparedness grant to conduct an FSE every five years. The purpose of any emergency preparedness exercise is to ensure that the state’s public health and medical services can respond to a complex public health incident quickly and effectively, mobilizing teams that are prepared and well-trained.

Our goal in these exercises is just as it is in our everyday work: to improve the lifelong health of Oregonians through our vision of a healthy Oregon. 

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Immi News You Can Use

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Welcome Summer!
Here is some great immunization news to start the season right!!

PBS: HPV vaccine dramatically cuts number of infections in teen girls

NBC: Dr. Paul Offit takes on the alternative medicine industry

OPB: Oregon lawmakers approve vaccine education bill

US News Healthday: Flu vaccine protects millions annually

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DATA POKES: June 2013

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Staff Update- Adam Boyette

The Oregon Immunization Program (OIP) is pleased to announce the hiring of Adam Boyette as a research analyst. Adam recently finished a PhD in anthropology from Washington State University. His dissertation work focused on children’s social learning among hunting and gathering societies in Africa. Despite his Indiana Jones-like appearance, Adam professes little experience with dangerous relics and obscure temples. Instead his main area of academic focus was on how ideas and culture are transmitted between individuals. Adam believes in an ‘epidemiology of ideas’ to explain how ideas, like diseases, can spread.

Adam is replacing Scott Jeffries, whose new role in OIP is working on an adolescent immunization grant. Adam will be in charge of the Population-Based Rates program and other special projects. Adam is looking forward to applying his research experience to public health and immunizations in Oregon. He is also extremely excited to talk about the birth of his now month-old daughter, Delphine. (Baby pictures on request).

Staff Publications
Steve Robison. Sick visit immunizations and delayed well-baby visits. Pediatrics, June 3rd, 2013.

Sick visits is one of the hardest barriers to address when trying to keep kids on an immunization schedule. Many kids are likely to be sick during one or more of the periods when shots are due in early childhood, and having a sick visit when immunizations are due is a common reason for infants falling behind.

AAP/ACIP policy calls for giving immunizations on sick visits for mild or moderate illnesses such as otitis media (earaches), regardless of whether there is a fever or not. However some providers worry that giving due immunizations on sick visits may discourage further shot seeking, or discourage returning to make-up missed well-baby checks.

A new study by Steve Robison in Pediatrics looked at whether giving sick visit shots discouraged returning for make-up well baby visits or further immunization seeking. Using ALERT and DMAP data, this study found that giving sick visit shots was not a risk for lower immunization or well baby visit rates. In contrast over a third of those who did not get a sick visit immunization failed to return for a make-up visit, and had significantly lower immunization rates and lower numbers of well-baby visits by age two. So avoiding sick visit shots has little benefit and carries a risk of children falling behind and not catching up on immunizations.

As a take-away message, if a child presents sick when shots are due consider giving them their immunizations. If you can’t, make sure that the parent has a make-up appointment scheduled before they leave the clinic.

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H7N9 and the 3 Ps of Pandemic Flu Preparedness

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By Tessa Jaqua
H1N1 will forever live in infamy in the minds of public health professionals and healthcare providers alike. It stands as the pinnacle of pandemic preparedness and lessons learned. When it was over and the dust had settled, state and county public health departments put all those quickly developed plans on the shelf to—hopefully—sit, unused for a good long while.

Then, in March of 2013, rumors started crossing the seas, whispers of H7N9 and human infection grew louder, and by April the World Health Organization announced that avian influenza A (H7N9), a type of flu usually seen in birds, has been identified in a number of people in China. Human infections with a new avian influenza A (H7N9) virus continue to be reported in China, with 131 cases and 36 deaths as of May 17. There was some mild illness in humans, however most patients have had severe respiratory distress. There have been no cases of H7N9 reported outside of China, and the CDC is not sounding the alarm quite yet, but this is an excellent time to dust off those plans and review the lessons we learned from the H1N1. If for no other reason, it’s always good to be prepared, just in case.

3 Ps of pandemic flu preparedness:
Plan Review: Remember all those notebooks, excel documents, word files, etc. that were filled to the brim with pressing and important preparedness and response information during H1N1 and possibly H1N5? Get them out, open them up, and review them. H7N9 may become pandemic in the fall, or maybe in 2015, or possibly never, but when you’ve planned and prepared for this before, it’s always important to review and update regularly.
Partner Check-up: We have lists and lists of push partners and community resources, but when was the last time they were updated? Are you sure that Tracy Smith is still the administrator of that residential care facility? Refresh the list, update numbers, addresses, and add or delete partners. These lists hold the key to true community response so it is integral that they be as current and as useful as possible.
Public Prevention: The best time to prepare for a pandemic outbreak is before it happens. Redouble your efforts to communicate disease prevention strategies to the public and communicate regularly with partners. Provide health literate, continual, easy access to preparedness tips and flu facts in redundant locations. Remember there is no such thing as being over-prepared.

H7N9 might not be a big bad pandemic flu strain yet, but the risk reminds us that preparation is our best defense.

For more information about the H7N9 strain visit the CDC website HERE.

    Second 2013 coalition roundtable scheduled

Immunize Oregon is excited to announce their second 2013 Round Table. This free, full day event will be held in La Grande, Oregon on Wednesday, June 19th from 9-4:30. Immunization updates including ALERT IIS, statewide immunization rates, and VFC developments will be covered. Dr. Jay Rosenbloom will give his keynote presentation: “Addressing Vaccine Resistance.”

The roundtable event is a wonderful opportunity for providers and interested stakeholders to learn more about immunizations. For more information, please visit our website, http://www.healthoregon.org/immunizeoregon or click here to register.

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Welcome Dawn and Jenny to OIP

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Dawn Lee and Jenny Nones

OIP welcomes two new members to the family. Dawn Lee is the new grant administrative specialist and back-up for the ALERTIIS helpdesk. Dawn has a varied background that includes clerking for the Superior Court of Clark County, 20 years in construction engineering and working for the Vancouver School District. She is a native Washingtonian and lives in Clark County with her husband and three dogs. Her family also includes three boys and two grandkids. Dawn’s favorite activity is donning her leathers, climbing on her hog and riding into the sunset. That’s correct: Dawn is a Harley-ridin’ biker chick. Her favorite recent trip was the Laughlin River Run in Nevada where she also visited the Grand Canyon. Her dream ride is to someday participate in the Sturgis Motorcycle Rally in South Dakota’s Black Hills.

Jenny Nones is a fiscal analyst who will divide her work time between OIP and the State Public Health Laboratory. Jenny just finished her Master of Public Administration in Healthcare Administration. She moved around a lot as a kid, but calls Salt Lake City her hometown. Jenny moved to Oregon about three years ago and has embraced quilting and wine touring. Her favorite winery is Anne Amie, which she says has the best parties. Jenny is also an avid traveler. Her most memorable trip recently was walking 350 miles in 30 days along the Camino de Santiago in Spain. She says she always travels alone and that adventure is perfect for solo travelers.

More staff news: Congratulations to Jody Anderson. She has been promoted from her provider services team administrative support role to full-fledged health educator! Jody’s territory includes:
• Washington County
• Crook County
• Harney County
• Deschutes County
• Jefferson County
• all Indian Health Service/Tribal clinics
• all Planned Parenthood clinics
• all Virginia Garcia clinics

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