Category Archives: CDC

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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Filed under All Posts, CDC, Oregon Immunization

NURSES NOTES

2013-14 influenza nomenclature
By Jeanine Whitney

Back in 2005 (and revisited in 2009), the Department of Health and Human Services made an offer. They would provide funds to businesses that could produce a recombinant influenza vaccine, build a manufacturing plant within the contiguous United States, meet a surge capacity of 50 million doses in six months and have vaccine lot releases within 12 weeks of a pandemic declaration. Well, four years later, they’ve done just that! 1

What does this mean for us? It means that the 2013-2014 influenza season will have some new vaccines available to choose from and a whole new nomenclature for us to learn.2

It all started when FluMist3 added a second B-strain to their live attenuated influenza vaccine making the first quadrivalent influenza vaccine for the U.S., LAIV-4.

There won’t be any LAIV-3.

Say good-by to TIV.

The previous TIV family of vaccines is now Inactivated Influenza Vaccine (IIV). There will be a mix of trivalent and quadrivalent injectable influenza vaccines available; IIV-3 and IIV-4.

Not only have we added a second B-strain but we have added the first two non-chicken based vaccines: recombinant influenza vaccine RIV-3 and the first non-chicken cell culture vaccine: ccIIV-3
What does this mean for right now? Unless your vaccine buyer made purchases last fall for these new formulations you may well only carry IIV-3. Just keep in mind that these and others may be available later this year and available for ordering for the 2014-2015 season.

See the table for the 2013-2014 season here.

• There are seven (7) IIV-3 regular vaccines from chicken eggs.
• There is one (1) RIV-3 recombinant vaccine and
• There is one (1) ccIIV-3 cell culture vaccine.
• There are (2) IIV-4 vaccines from chicken eggs. [Fluzone IIV-4 was just approved4.]
• Keep in mind that influenza vaccine is recommended for all individuals’ ≥6 months of age with at least 17 different presentations from which to choose.

Happy shopping!

1. Donabedian, A. 2012, United States Department of Health and Human Services. Prospects for sustainable influenza pandemic preparedness.
2. Interim Recommendations: Prevention and control of influenza with vaccines: Recommendations of the Advisory Committee on Immunizations Practices, (ACIP) 2013.
3. Vaccines, Blood & Biologicals. February 29, 2012 approval letter – FluMist®Qudarivalent.
4. Vaccines, Blood & Biologicals. June 7, 2013 approval letter – Fluzone Quadrivalent.

IMMIE NEWS YOU CAN USE:

Pneumonia vaccine said to reduce U.S. hospitalizations (Reuters)

Maternal Tdap vaccine increases pertussis antibodies in infants (Healio)

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Filed under All Posts, CDC, Nurses Notes, Vaccine ordering

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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Filed under All Posts, CDC, Oregon Immunization, Preparedness, Public Health Heroes

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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Filed under All Posts, CDC, Flu, Oregon Immunization, School Law

Upcoming CDC Training in Washington State

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Filed under All Posts, CDC, VFC

Oregon shines at the 2011 National Immunization Conference

The 45th annual National Immunization Conference was held earlier this spring. Several of the Oregon Immunization staff were fortunate enough to attend and present. Our state program is regarded highly for the innovate approaches we take towards immunization practice. We’re so proud of Oregon’s team and the hard work done by our public and private clinics! We thought you might like to hear/see what Oregon staff presented at this year’s conference. 

 To view/listen to all of the presentations, click on the following link:  http://cdc.confex.com/cdc/nic2011/webprogram/meeting.html

Kick-off Award Ceremony:

Our very own Lorraine Duncan (she is the black dot in the middle) presents the 2011 Natalie Smith Award to Susan Lett, MD, MPH, Medical Director, Immunization Program, Massachusetts Department of Public Health. The award is the highest form of recognition for Immunization Program Managers and recognizes contributions and accomplishments in the area of vaccine-preventable disease prevention.

Presentations by Oregon Immunization Program Staff:

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How Vaccine-Seeking Factors Into Disparities in Adult Influenza Vaccination
Holly Groom, MPH, Research Analyst, Oregon Department of Human Services/CDC; Pascale Wortley, MD, MPH; Fan Zhang, MD, PhD, MPH

Background:  Racial/ethnic disparities in influenza vaccine uptake among adults are longstanding; research suggests they result from multiple factors. Previous studies suggest that influenza vaccine-seeking behavior may be an important aspect to consider when evaluating disparities in vaccination coverage.

Objectives:  To determine if there are differences—by race or ethnicity—in influenza vaccination-seeking behavior among adults 65+ years of age.

Follow this link to view/listen to this presentation: http://cdc.confex.com/cdc/nic2011/webprogram/Paper25415.html

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Continuous Temperature Tracking: The Secret Lives of Vaccines
Albert Koroloff, MPH, Public Health Educator, Oregon Health Authority

Background:  Vaccines for Children (VFC) is a federally funded program that provides no-cost vaccines to providers for children who might not otherwise be vaccinated because of inability to pay. The Section 317 program is a discretionary federal grant program that provides vaccines to providers for underinsured children and adolescents not served by the VFC program. Both programs depend on the safe transport and storage of vaccines: sensitive biologicals that require very specific storage conditions. To protect this federal investment, participating VFC/317 clinics are required to check and record their vaccine storage temperatures at least twice a day.

In 2007 the Oregon Immunization Program (with approval by CDC) initiated an enhanced temperature tracking requirement. This requirement states that Oregon VFC/317 clinics will “use calibrated and NIST or ASTM certified continuous-tracking thermometers or other OIP-approved devices in both refrigerator and freezer units used to store VFC vaccines.” 

Follow this link to view/listen to this presentation: http://cdc.confex.com/cdc/nic2011/webprogram/Paper25507.html

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IIS Data Migration: Cleaning House Before the Big Move
Mary Beth Kurilo, MPH, MSW, ALERT Director, Oregon Immunization Program; Deborah Rochat, BS; Don Dumont, PhD

Background:  In 2010, the Oregon ALERT Immunization Information System (IIS) migrated from a locally developed data warehouse platform to a customized public domain clinical records model IIS. Approximately 4.5 million demographic records and 31 million immunization records collected since 1996 were cleaned, standardized and migrated to Oregon’s new system. Oregon utilized this transition to implement stronger data standards and business rules, including those produced through MIROW (Modeling Immunization Registry Operations Workgroup).

Follow this link to view/listen to this presentation: http://cdc.confex.com/cdc/nic2011/webprogram/Paper25505.html

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Adolescent Vaccination Uptake Among Students Participating in Tdap-Only Clinics in Deschutes County, Oregon
Holly Groom, MPH, Research Analyst, Oregon Health Authority; Heather Kaisner, BA; R. Bryan Goodin, BS, MPH; Collette Young, PhD

Background:  In 2008, Tdap (tetanus toxoid, diphtheria toxoid, acellular pertussis) vaccine was added as a school entry requirement for children entering 7th and 8th grade in Oregon.  Many local health departments provided Tdap through school-located vaccination clinics in 2008, using vaccine provided at no cost by the Oregon Immunization Program.  A condition of receiving free vaccine was that all administered doses had to be entered in Oregon’s Immunization Information System (IIS).

Objectives:  To examine uptake of all adolescent- recommended vaccines among children who received Tdap in a school setting.

Follow this link to view/listen to this presentation: http://cdc.confex.com/cdc/nic2011/webprogram/Paper25251.html

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Adding up the Benefits of Billing for Influenza Vaccinations Administered in School-Located Clinics: Experiences From Two Oregon Counties
Holly Groom, MPH, Research Analyst, Oregon Department of Human Services/CDC; Suchita Lorick, DO, MPH; Kelly Martin, MPH; Robert Moore, MD; Julie O’Neil, MPH; Rosa Duran; Bo-Hyun Cho, PhD; Garrett Asay, PhD; Mark Messonier, PhD

Background:  Oregon’s Local Health Departments (LHD) have been coordinating with schools to provide influenza vaccination in school-located clinics at no cost to schools and parents since 2006. In 2010, after a 3-yr pilot to assist LHDs in developing partnerships, the Oregon Immunization Program ceased providing LHDs influenza vaccine at no cost for school-located clinics.  In an effort to develop more sustainable approaches for vaccine delivery to school-aged children, two counties piloted a project in the 2010-2011 influenza season to bill for influenza vaccine and/or vaccine administration in school clinics.  

Follow this link to view/listen to this presentation: http://cdc.confex.com/cdc/nic2011/webprogram/Paper25253.html

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Poster presentations:

Maureen Cassidy presents her work on increased Tdap uptake to protect the most vulnerable: infants, and to assess and improve Tdap administration by Oregon birth centers.

Carlos Quintanilla presented a poster on the pharmacy internship partnership between Pacific University and the Oregon Immunization Program.

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Filed under ALERT IIS, All Posts, CDC, Oregon Immunization, VFC

CDC Study Focuses on Two-dimensional Vaccine Barcodes

Two-dimensional barcode technology could be used to improve patient safety, record keeping, and data collection.  You may have already seen these barcodes on airline boarding passes, bank statements, or items in the grocery store. Even within a small amount of space—such as on a vaccine vial—they can store a lot more information than traditional linear barcodes.

Many vaccines have linear barcodes on their labels, but these only include the product identifier and don’t include the lot number and expiration date needed to comply with the National Childhood Vaccine Injury Act. This means that we still have to record that information by hand. Two-dimensional barcodes (also called data matrices) can be easily scanned in a patient setting by a handheld device. Data needed for documentation, including vaccine type, manufacturer, lot number, and expiration date, could then be uploaded into practice management systems and a patient’s electronic health record (EHR).

To help the Centers for Disease Control and Prevention (CDC)  understand the implications these barcodes may have on immunization practice, RTI International, through a contract with CDC, is asking immunization providers, even those who do not currently use or plan to use the barcode technology, to participate in a 10-minute Vaccine Barcoding Survey.

To participate—and to be eligible for a chance to win 1 of 10 iPads—go to https://vaccinebarcodingsurvey.rti.org. Respondents will be entered into a raffle to win 1 of 10 iPads as a thank you. 

Several groups, including CDC, the American Academy for Pediatrics, and vaccine manufacturers, have discussed using enhanced barcodes for many years.  In August 2010, draft updated guidance from the U.S. Food and Drug Administration (FDA) stated that FDA will consider requests from vaccine manufacturers to use alternate coding technologies, such as two dimensional barcodes, that encode lot number and expiration date information in addition to the national drug code.

Two-dimensional barcoding technologies could improve patient safety, save costs associated with vaccination documentation, and facilitate data exchange to immunization information systems (IIS or registries) and to EHRs. Immunizers without EHRs or who do not scan vaccines will not have to change their practices, even if the new barcodes are introduced, because the necessary information will still be printed on the vaccine label.

Before starting the survey, you will need to know how many doses of childhood, adolescent, adult, travelers’, and influenza vaccines you give per year. This information will improve our ability to understand responses we receive, but if this information is not available, please complete the rest of the survey. A sample survey is available for download from the website. All responses are confidential and will only be used to inform CDC’s vaccine barcoding study. For questions and comments, contact barcodingsurvey@rti.org.

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