Oregon’s Childhood Immunization Champion

The Oregon Immunization Program is proud to announce that Christine Wysock, RN, ADN, Corporate Infection Preventionist for the Yakima Valley Farm Workers Clinics, has been selected as the Centers for Disease Control and Prevention (CDC) Childhood Immunization Champion for Oregon.  CDC and the CDC Foundation hold this annual awards program to honor immunization champions across the 50 U.S. states, 8 U.S. Territories and Freely Associated States, and the District of Columbia during National Infant Immunization Week (April 16-23, 2016). Christine was nominated and selected from a pool of health professionals, community advocates, and other immunization leaders for making a significant contribution to public health in Oregon through her work in childhood immunization.

or-wysock

In her capacity as a nurse overseeing vaccinations in three of Yakima Valley Farm Workers Clinics, Christine’s efforts to establish and maintain registries for infants and children have proven to be among the most successful in Marion County. Yakima Valley Farm Workers consistently rank among the highest in the county in AFIX reports on immunization coverage. Thanks in part to her efforts to educate her community and advocate for improved immunization practices, vaccination rates have risen in Woodburn from low 70th percentile to the 90th percentile within the county.

Young children rely on the champions in their lives to keep them safe and healthy. When families, healthcare professionals, and public health officials work together, all children can be protected from serious and deadly vaccine-preventable diseases.  Christine Wysock is an inspiration to all of us who care about children’s health in Oregon.  We are pleased and honored to congratulate her on this well-deserved award.

Please visit the Oregon Health Authority Immunization Program website to read about Christine and Oregon’s other distinguished nominees, Dr. Joel Amundson and Dr. Jay Rosenbloom.  http://public.health.oregon.gov/PreventionWellness/VaccinesImmunization/Pages/index.aspx

To read Christine Wysock’s profile on the CDC’s website, and to learn more about CDC’s Childhood Immunization Champion Award program, please visit http://www.cdc.gov/vaccines/champions.

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Janis Betten: Immunization Champion

Janis Betten

Janis Betten & her granddaughter

Ever wonder what goes on “behind the scenes” at the Oregon Immunization Program? Which staff have been there the longest, and who has the historical knowledge? How are school immunization laws managed? One lady, very dear to our heart, Janis Betten, Health Educator, can tell it all. If you’ve never met Janis, I hope some day you do. She’s the kindest, most gentle-hearted person you’ll ever meet. Janis Betten has had her hand in immunizations for over 34 years. This month we will celebrate her retirement and mourn the loss of such foundational knowledge.

Janis’ immunization journey began when she started working with Head Start in 1979, reviewing immunization records for siblings of children in Head Start which included visiting migrant camps in Washington County.   In 1978, a large measles outbreak occurred in Oregon, which caused a huge need to track down 100,000 + immunization records for Oregon’s schooled-aged children. The Oregon Citizens for Immunizations Inc. (OCII) was formed to create strategies to keep school-aged children safe if another outbreak was to occur. OCII was a group of partners consisting of non-profit agencies, local volunteers, county, state employees AND our lovely Janis Betten. This organization worked on legislation to revise the immunization school law requirements passed in 1973. This revision would require schools to require immunization documentation for every student, providing more teeth to the existing law.

Janis then went to work for the Multnomah Education Service District. One of the most memorable moments in her career was the first Oregon school immunization exclusion day in April 1982. There were 29,000+ exclusion orders issued in Multnomah County. Many county staff groups came together to hand write all 29,000+ exclusion letters at the warehouse at the old Ford Building on SE 11th and Division, and Janis was an integral part of that successful partnership. This was also the beginning of a professional relationship and friendship with Peggy Lou Hillman, who was Immunization Coordinator for Multnomah County Health Department. Janis and Peggy have shared a position with the Oregon Immunization Program for the last 12 years.

About that same time, Janis became a part of the staff for the Oregon Immunization Program.   As schools began to develop electronic means of tracking the immunization records of their students, Janis took on the enormous roll of working with various computer system developers, reviewing their results and ensuring that their assessments of those records complied with Oregon requirements. Janis also kept her forecasting skills highly tuned by assisting at Multnomah County immunization clinics and providing technical forecasting support for the state registry and the state immunization tracking systems used by local health departments.

Janis’ secret to a long career is to always be curious to learn more. In her early career, Janis always looked for part-time, short-term work in fear she would become bored with a job. Then she found, strong, committed women within the field of public health, and the challenge of an ever changing field, which kept her in immunizations for 34 years. When asked what advice she would give someone seeking a long career in public health, Janis shared that people should seek out a mentor, someone who has had experience in the field. She also advised people to take every opportunity for advancement, and get as many experiences and professional development opportunities as possible.

In her retirement Janis looks forward to more time to care for her mother and sister and spending time with her son, daughter-in-law and granddaughter, highlighting the kindness Janis has in heart in caring for her family.

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Pharmacists Impact on Immunization

Quynh Tran, Pharm.D Candidate 2016 Pacific University School of Pharmacy The role of pharmacists has come a long way from the classical “lick, stick, and pour” dispensary role (that is, “lick and s…

Source: Pharmacists Impact on Immunization

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Pharmacists Impact on Immunization

Quynh Tran, Pharm.D Candidate 2016

Pacific University School of Pharmacy

The role of pharmacists has come a long way from the classical “lick, stick, and pour” dispensary role (that is, “lick and stick the label, count and pour the pills”) and is experiencing significant growth and development. With the expansion in the scope of practice, community pharmacists are able to take on a stronger role in support of public health to improve vaccination rates and reduce the burden of vaccine preventable diseases. According to the American Pharmacist Association, three proposed roles that pharmacists can play in improving immunization rates include acting as immunization advocates, acting as facilitators and hosting other health care professionals to provide immunizations to the public, and lastly, taking on active roles as immunizers.

Pharmacists in all states are permitted to administer vaccinations, and the role of pharmacists in adult immunizations has increased significantly over the past few years. In 2011, Oregon pharmacy law allowed pharmacists to immunize adolescents down to age 11, and then in January of 2015, the law further lowered the age to 7. With less than half of adolescents receiving their yearly influenza vaccination, this change in pharmacy law can help more children get vaccinated and provide better access to immunizations.

The Oregon Immunization Program evaluated the impact of this change in the Oregon pharmacy law by using data from the Oregon ALERT Immunization Information System (IIS) limited to Clackamas, Marion, Multnomah, Polk, Washington and Yamhill Counties. The program compared influenza immunization rates before 2011 (2001 – 2010) and after the law was passed in 2011 (2011 -2014), between adolescents aged 11 -17 and those aged 7 – 10. Results revealed that between 2007 and 2014, adolescent influenza immunizations at community pharmacies increased from 36 to 6,372, with the largest increase happening after the law change, from 262 in 2010 to 2,083 in 2011. This evaluation demonstrated that expanding the scope of the pharmacist in immunizing adolescents can provide better accessibility to an adolescent population who may otherwise be unlikely to receive immunizations at clinics. This in turn can substantially help increase adolescent influenza immunization rates.

References

  1. Robison, Steve G. (2016). Impact of Immunizing Pharmacists on Adolescent Influenza Immunizations. Manuscript submitted for publication.
  2. Rothholz, Mitchel C. (2013). Role of community pharmacies/pharmacists in vaccine delivery in the United States [PowerPoint slides]. Retrieved from http://www.pharmacist.com/role-community-pharmaciespharmacists-vaccine-delivery-united-states-0

 

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Filed under ALERT IIS, DataPokes, Education, Flu, Oregon Immunization, Research, School Law, VFC

Why We Care About HPV

By Isabel Stock, Colorado State University

Oregon Immunization Program Intern

The idea immunizing your child to prevent a sexually transmitted infection may seem foreign to many parents. People across the world have different views regarding vaccination, but all can agree on cancer prevention. It is our duty as public health advocators, medical professionals and community stakeholders to promote the importance of the HPV vaccination. Here are some astounding numbers to show the impact Human Papilloma Virus has compared to other diseases that we commonly vaccinate children for:

  • 1,904 polio deaths in the U.S. in 1950 (near the height of the epidemic)
  • 450 measles deaths every year in the U.S. before the vaccine
  • 500 tetanus deaths every year before widespread use of the vaccine in the U.S.
  • 100 chickenpox deaths every year in the U.S. before introduction of the vaccine
  • 4,000 HPV-related cervical cancer deaths in the U.S. every year

With 12,000 women being diagnosed every year with cervical cancer, it’s noteworthy that 1 in 3 of them do not survive for five years, especially when the HPV vaccination and screening can prevent up to 93% of these cancers. Other than the cervix, HPV is associated with cancer of the anus, vulva, vagina, oropharynx and cervix in women and HPV related cancers in men are found in the anus, oropharynx and penis.

With 79 million people in the U.S. currently infected with HPV, 14 million new infections every year, the National Cancer Institute has released a Call to Action. In the U.S. 40% of females and 21% of males are receiving all three doses of the HPV vaccine. In Oregon, 36.4% of females and 20.6% of males are receiving all three doses of the HPV vaccine. It is clear that the U.S. will fail to meet the Healthy People 2020 goal of 80% HPV vaccination rate for all three doses. We are faced with a significant public health threat if we don’t take immediate action to improving our vaccination rates.

Here are the best ways to begin improving HPV rates in your clinic today:

  • Know how to frame your conversation regarding HPV with parents and provide them with educational resources
  • Start the vaccine on time; schedule wellness visits at age 11 and 12
  • Schedule follow-up visits before they leave the office
  • Practice reminder/recall for 2nd and 3rd doses
  • Provide walk-in or immunization only visits
  • Immunize at sports physicals

For more information on how to implement these actions, go to: https://public.health.oregon.gov/PreventionWellness/VaccinesImmunization/ImmunizationProviderResources/vfc/Documents/AFIXQIActionSteps.pdf
HPV kids

References:

https://karenvaxblog.wordpress.com/2016/01/14/im-pro-vaccine-but-that-hpv-vaccine/

http://www.cdc.gov/hpv/parents/vaccine.html

https://www.mdanderson.org/content/dam/mdanderson/documents/prevention-and-screening/NCI_HPV_Consensus_Statement_012716.pdf

www.cdc.gov/vaccines/teens

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Framing the HPV Conversation

By Isabel Stock, Colorado State University

Oregon Immunization Program Intern

Many parents who choose to vaccinate their children are faced with the worry, “Do I vaccinate my child for Human papillomavirus?” According to the 2012 National Teen Immunization Survey, one of the main reason parents that didn’t intend to vaccinate their children against HPV was a lack of healthcare provider recommendation. It’s time to frame the conversation between parents and providers on the importance of the HPV vaccination.

As a provider, it is important to recommend HPV vaccine as you would any other, especially on the same visit as other vaccinations. Here is a list of other important factors to highlight when discussing the HPV vaccine with parents:

  • It is one of the only vaccines available to prevent cancer.
  • HPV infection can be passed through any type of sexual activity, not just intercourse. Some types of HPV are spread by skin-to-skin contact.
  • Multiple research studies have shown that HPV vaccine does not make kids more likely to be sexually active.
  • HPV vaccine has a strong safety record. More than 62 million doses have been given in the United States, and there are no serious safety concerns.
  • Put HPV first when listing the vaccines that the child needs during the visit. For example, “Your child needs three shots today: HPV vaccine, meningococcal vaccine and Tdap vaccine.”
  • Vaccinate for HPV well before children might be exposed to it, just as you would for other diseases such as measles.
  • Emphasize your personal belief in the HPV vaccine, and let them know that you have given it to your son/daughter/family member/friend. This is a powerful tool to help parents feel more secure about their decision

All of these tips will help educate the parent to make a decision and avoid missed opportunities to increase HPV vaccination rates. There are many more resources available to frame the conversation between providers and parents on the CDC website. Below is a great resource for providers to start.

         HPV Tips FINAL

When talking with vaccine hesitant parents, it is helpful to use a communication approach that guides rather than directs and encourages the parent to ask questions. Engaging with good communication strategies allows parents to come to a decision on their own, using evidence based facts delivered by the provider. This technique has been shown to help families and providers address concerns in a way that allows the provider to convey respect and empathy while sharing medical information. For more information on effective communication strategies see, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3480952/.

To help parents understand just how safe, effective, and necessary this vaccine is for their children check out the National Cancer Institute’s recent Call to Action at, https://www.mdanderson.org/content/dam/mdanderson/documents/prevention-and-screening/NCI_HPV_Consensus_Statement_012716.pdf. Now, more than ever, it is important we give parents all the necessary facts about HPV vaccination to give their child the best possible chance to live a cancer free life.

References:

http://www.cdc.gov/hpv/hcp/index.html

http://www.cdc.gov/hpv/hcp/answering-questions.html

http://www.cdc.gov/hpv/hcp/speaking-colleagues.html

http://www.cdc.gov/vaccines/who/teens/vaccines/vaccine-safety.pdf

https://www.mdanderson.org/content/dam/mdanderson/documents/prevention-and-screening/NCI_HPV_Consensus_Statement_012716.pdf

http://bmcpediatr.biomedcentral.com/articles/10.1186/1471-2431-11-74

 

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We Can Prevent Cervical Cancer

By Katherine McGuiness, MPH, MSW

ScreenWise Engagement and Eligibility Coordinator, Oregon Health Authority

January is Cervical Health Awareness month, which is a great time to reflect on the fact that most cases of cervical cancer are preventable.  The two main ways we have of preventing cervical cancer are through the HPV (human papillomavirus) vaccine and cervical cancer screenings like pap smears and HPV co-testing and subsequent treatment.

 HPV

HPV Vaccine

The new Gardasil vaccine protects against the 9 of the most common HPV strains, many of which are found in a variety of cancers, including 90% of cervical cancers. The vaccine can be given between the ages of 9 and 26, with a preference of getting it earlier than later in age. Getting the HPV vaccine early is one of the best ways to prevent cervical cancer.

Cervical Cancer Screenings

Pap tests and HPV tests are screening tests that help prevent cervical cancer, or find it early. The HPV test looks for the virus that causes most cervical cancers. Currently, the HPV test is recommended for those over 30. The Pap test looks for precancers- like changes in cells on the cervix that can turn into cancer if they are not treated. National guidelines suggest that pap testing is recommended for people aged 21-65 with a cervix.

For people who have insurance, most insurance plans cover the cost of cervical cancer screenings. For those that do not have insurance, Oregon’s ScreenWise Program may be able to cover the cost. ScreenWise covers the cost of breast and cervical cancer screenings for people who live in Oregon, are uninsured, and meet certain income criteria. There are ScreenWise clinics all over the Oregon. To find out more about eligibility and clinic locations, call 1-877-255-7070.

Are you interested in having your clinic provide ScreenWise services?

Contact Katherine McGuiness at (971)673-0343 or Katherine.h.mcguiness@state.or.us

Sources:

http://www.cdc.gov/vaccines/hcp/vis/vis-statements/hpv-gardasil-9.html

http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/cervical-cancer-screening

http://www.nccc-online.org/images/pdfs/HPV_fact_sheet_2015.pdf

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