Category Archives: Oregon Immunization

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

Antibiotics and Public Health: A Collaborative Elective for Students and Community

by Tessa Jaqua, AWARE Program Coordinator


As fall ushered in a change of season, the Oregon AWARE program once again armed itself for the onslaught  of colds, flus, and other viral illnesses that contribute to the overuse of antibiotics in our community. The Oregon Alliance Working for Antibiotic Resistance Education (AWARE) is the state’s coalition whose mission is to encourage the appropriate use of antibiotics and aims to reduce the problem of antibiotic-resistant bacteria in Oregon.

As a statewide coalition, Oregon AWARE takes advantage of the amazing resource and fresh minds from the innumerable educational and community organizations that are committed to the health and wellness of Oregonians. Two of these long time partners are conveniently located right across the river in the AWARE program’s backyard. While the Oregon State University School of Pharmacy and Oregon Health and Science University’s Physician Assistant (PA) program made themselves at home in the new collaborative sciences building on the south Portland waterfront, 15 students from both programs decided to honor the name of their new home by participating in a new collaborative elective course; Antibiotics and Public Health.

These pioneering students spent 10 weeks learning about the effects of antibiotic resistance globally and locally, the benefits of judicious antibiotic use, preventive vaccinations, and educational techniques for reducing overuse to preserve this life-saving resource. Each topic was presented with consideration and professional feedback from PAs, pharmacists, and immunization and antibiotic resistance educators.

Students were charged with completing not only lessons and projects,  but also organizing and running the Oregon AWARE program’s annual Get Smart About Antibiotics Week event, AWARE on the Square. Students organized everything from volunteering, logistics and vaccination provision, to media and community outreach for this event in Portland’s Pioneer Square. Working in interdisciplinary groups to maximize efficiency and promote participation from fellow students, these students assured that the event was a rousing success. Students educated or surveyed over 725 Oregonians and provided no cost flu shots to 46 uninsured/underinsured adults.

At the end of the term, students reflected on the course with positivity and excitement at getting to work with students from other programs and disciplines. They credited their success on final projects and AWARE on the Square to having varied and unique input from their fellow students and instructors. Many hope to carry interdisciplinary cooperation into other areas of their programs.

Oregon AWARE, the OSU School of Pharmacy, and OHSU PA program are pleased with the student’s success and the service they were able to provide to the community through events and student projects.  The programs hope to continue the elective in the fall of 2016 and plan to expand registration up to graduate nursing and medical students as well.

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HPV: Same Way, Same Day

Source: CDC Preteen Vaccines

Did you know that the female Hispanic patients in your practice have a greater chance of developing cervical cancer later in life than non-Hispanic patients? United States Cancer Statistics on cancer incidence show Hispanic women have the highest rates of cervical cancer in the United States. You can reduce this disparity and protect your patients’ future health with HPV vaccination.

You are the key to cancer prevention. Research shows that an effective recommendation from a healthcare professional is crucial to a parent’s decision to get the HPV vaccine for their child. One way to make an effective recommendation is to recommend all routine adolescent vaccines—Tdap, meningococcal, and HPV—at the same time without singling out HPV vaccine or presenting the vaccine as optional. If parents ask why HPV vaccination is needed, remind them that HPV vaccine is for cancer prevention.

Prevention is easier than treatment. More than 4,000 women die of cervical cancer every year, even with screening and treatment. Over 27,000 men and women in the U.S. are diagnosed with a cancer caused by HPV every year—that’s a new case every 20 minutes! HPV vaccine could prevent the majority of these cancers from ever developing, but only 57 percent of adolescent girls and 35 percent of adolescent boys have received the first dose, according to the most recent data from the Centers for Disease Control and Prevention (CDC). . In comparison, 86% of teens have received Tdap and 78% have received meningococcal vaccines.

Recommend HPV vaccine the same way and the same day you recommend the Tdap and meningococcal conjugate vaccines. For example, start your vaccine discussion with the parents of preteen patients by saying: “Your child needs three shots today—meningococcal, HPV, and Tdap vaccines.”

For more information on having successful conversations with parents about HPV vaccination, and to learn how to answer common questions, download CDC’s Tips and Timesavers factsheet at This site also has patient education materials in Spanish that your staff can download and print for the parents of your Hispanic patients.

If parents have concerns about paying for vaccines, the Vaccines for Children (VFC) program may be able to assist. The VFC program provides vaccines for children ages 18 years and younger who are uninsured, Medicaid-eligible, and/or American Indian or Alaska Native. Send parents to to learn more about the VFC program.

You can find out more about the Oregon VFC Program by clicking here.

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Oregon HPV vaccine quarterly report

by Sara Beaudrault

The Centers for Disease Control and Prevention (CDC) now provides quarterly human papillomavirus vaccine (HPV) reports to state and local immunization programs to document progress toward reaching the Healthy People 2020 goal of 80% coverage with three doses. Since the HPV vaccine’s introduction, coverage at the national level and in most states, including Oregon, has increased at a very slow pace.

Oregon’s first quarterly HPV report is available on the Oregon Immunization Program’s Adolescent Immunizations webpage. Other reports and resources are also available on this page, including a link to CDC’s You Are the Key to Cancer Prevention toolkit for healthcare providers.

With over 14 million new HPV infections each year, most acquired during the teen years and 20s, increasing HPV vaccination uptake among today’s young people is critical to prevent future HPV-associated cancers.

CDC and the Oregon Immunization Program urge healthcare providers to strongly recommend all adolescent vaccines recommended for boys and girls aged 11-12 years. We encourage providers to recommend and promote HPV vaccine just as they recommend Tdap, meningococcal, and influenza vaccines.


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The Journey to Become a Certified Medical Assistant

by Jeanine Whitney RN, MSN, NHE-C

Did you ever wonder about the qualifications of the person who holds the power of the needle? Vaccines are being given more and more by healthcare workers other than a Registered Nurse. In fact, chances are good that the person holding the syringe is not an RN but could well be an immunizing pharmacist or a Medical Assistant (MA). There are many categories of MAs, each with its own education and certification requirements. In this article, we explore the unique education and certification requirements for Certified Medical Assistants (CMA).

All MAs undergo a rigorous course of study, but the American Association of Medical Assistants (AAMA)-required course of study for CMAs must be certified by the Commission on Accreditation of Allied Health Education Programs (CAAHEP: and/or the Accrediting Bureau of Health Education Schools (ABHES: This is different from many MA programs, whose accreditation falls under the school, and it means that CMA students everywhere receive standardized training that conforms to CAAHEP requirements.

The CMA training curriculum ensures that CMA students gain competency in a wide variety of areas. I contacted Virginia Chambers1, CMA (AAMA), BS, MHA, who is the Medical Assisting Department Co-Chair at Portland Community College (PCC). She shared the list of required competencies for a CMA. By the time students sit for their exams, they are well-versed in basic practice finances, communication, managed care and insurance, medical coding, legal issues, and of course, patient care. CMAs are able to step in and fill any number of roles for their employers because of this comprehensive training.

CMA certification exams also differ from those for other MAs. I took the opportunity to speak with Paula Purdy2, CMA (AAMA), who is Director of Operations for Medical Society Services, Inc., about these differences.

“The one big difference,” according to Ms. Purdy, “is that the AAMA certifying board is the only medical assisting certifying agency that uses the National Board of Medical Examiners (NBME) as the consultant for its certification examination.  CMA (AAMA) exam scoring metrics are processed by the same professional psychometricians who provide this service for United States Medical Licensing Exam (USMLE) candidates. The CMA (AAMA) exam is a highly valid and reliable indicator of the knowledge necessary to be a competent medical assistant.” The AAMA exam is not easy. The overall student pass rate is 67 percent.  At the time of this writing, PCC is the only school in the Portland metropolitan area that has a 95 percent or above student pass rate.

The AAMA requires recertification every 5 years. In those five years, the CMA (AAMA) must earn 60 continuing education units (CEU).These CEUs must reflect the breadth of training areas.  Ten CEUs must be administrative; ten CEUs must be general; and ten CEUs must be clinical. The CMA can choose how to fulfill the remaining thirty CEUs. If the CMA (AAMA) doesn’t complete the CEUs on time, they have six months from the expiration date to do so or they must sit for the exam again.

Keep in mind that all MAs are under the direct delegation of the hiring physician. An RN can observe and teach an MA. RNs can also supervise an MA and delegate tasks to them according to Oregon State Board of Nursing (OSBN) Nurse Practice Act Division 45 and 47. RNs can delegate several types of tasks to MAs, but immunization injections are not one of the tasks. The hiring practitioner delegates immunization injections to the MA.

Are any Oregon employers putting credentialed healthcare workers to work? Yes. Cathy Cassata in CMA Today magazine3 (Nov-Dec 2013) talks about CMAs and the Oregon Health and Science University ambulatory care services. “As of April 1, 2013, all newly hired medical assistants are required to become CMAs (AAMA) within six months of being hired.”  We can add Providence, Legacy, Kaiser, and Adventist to the list of employers that actively recruit AAMA-certified individuals for their practice sites. Oregon has approximately 1,200 CMAs (AAMA) in practice.

The next time you get a vaccine, take a good look at the initials after the name of the person holding the needle. If there are none, then ask. It may well be a CMA (AAMA). If so, you are in well-educated and credentialed hands.

1PCC-Willow Creek:

 2 Certified Medical Assistant (CMA) American Association of Medical Assistants (AAMA) ®, the current Public Affairs Liaison Team Manager and past State President (2013) of the River Cities Chapter of Medical Assistants (CMA,AAMA): Ms. Purdy currently serves on the AAMA Board of Trustees.

3Cassata, Cathy. Trailblazers: Oregon employer hitches its wagon to CMAs (AAMA) (OM). Nov-Dec 2013. CMA Today. Listed at

Note: The following original sentence was corrected on 12/8/14 in the text below: An RN can observe, teach and report on an MA but cannot delegate tasks or duties to an MA. More information on the Nurse Practice Act, which is mentioned in the corrected sentence, can be found at:

Jeanine Whitney is an active member of the PCC Willow Creek Education Advisory Team and has worked with the Program Advisory Committee at Anthem College.

For additional certification information, please contact individual institutions or the Accrediting Bureau of Health Education Schools at

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Upcoming Portland Metro Area Flu Vaccine Clinics

The following flu vaccine clinics are taking place in the Portland Metro Area. All of these clinics will provide no cost flu vaccine to adults, regardless of insurance status. We will also be posting about upcoming clinics on the Flu Oregon and Oregon Immunization Program Facebook pages

November 5, 2014 from 12pm-5pm at Transition Projects, 650 NW Irving St, Portland Or (sponsored by Family Care)

November 11, 2014 varying times at 6 Legacy Health Locations (please visit to find more details, ages served and vaccines provided)

November 19, 2014 from 1pm-4pm at JOIN, 1435 NE 81st Ave, Portland Or (sponsored by Family Care)

November 21, 2014 from 7:30am-4:30pm in Pioneer Courthouse Square in Portland, Or (sponsored by AWARE- please visit for more details)

November 22, 2014 from 9am-5pm at the American Diabetes Expo at the Oregon Convention Center (sponsored by Family Care)

If you have an upcoming flu clinic anywhere in Oregon or bordering areas you would like to promote, please email

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Open Invitation to Immunize Oregon Coalition Meeting on July 29th

Please join us for Immunize Oregon’s July meeting on July 29th, 2014 from 11:45-2pm! The meeting will take place at the Portland State Office Building, 800 NE Oregon St, Portland OR 97232 in room 1B.

We are excited to have Fred Troutman and Karen Tetz, professors at Walla Walla School of Nursing talk about an initiative to bring nursing students to rural India to provide vaccines. We will also hear from Scott Jeffries from the Oregon Immunization Program about using Reminder/Recall to raise a clinic’s immunization rates, specifically focused on adolescents. Alison Alexander from Immunize Oregon will be talking about the new National Adult Vaccination Standards and other ways to improve community immunity. Lunch will be provided.

If you are interested in attending in person or by phone/webinar, please RSVP by Friday, July 25th to

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Take a Peek Inside Two Local Health Department Immunization Programs

by Yuliya Goldman

Local health department (LHD) immunization programs all strive to achieve the same goal: prevent disease by providing timely and accessible immunizations. Consequently, programs carry out many similar activities. Still, each county in Oregon is unique, with its own population, geography, and economy.  Local Health Department staff are skilled at building their programs to meet the unique needs of the people they serve. Here we take a look at two immunizations programs located in very different settings: one urban and one rural.

Multnomah County

Introduction to Multnomah County Immunization Program

Multnomah County has the distinction of being the smallest county geographically, but the largest when looking at population. More than 750,000 people live in Multnomah County, according to the 2013 census. The Immunization Program in Multnomah County strives to meet the needs of its large and diverse population through direct services, partnerships, and outreach.  

The Multnomah County Health Department is comprised of two large divisions:  the primary care branch called Integrated Clinical Systems (ICS); and the public health branch called Community Health Services (CHS).  The ICS clinics, consisting of 8 primary care sites, 13 School Based Health Centers and 3 corrections-based facilities, all provide childhood, adolescent, and adult immunization services to their patients.   Immunizations are also provided at the STD Clinic and the safety net Community Immunization Program (CIP). Ginni Schmitz and Liem Hoang of the CIP provide technical support to all the clinics that provide immunization services to the public. 

Community Outreach

With a diverse population of over three quarters of a million people, identifying community needs plays an important part in providing appropriate services. This is where Melissa McKinney comes in. She serves as the Communicable Disease Services Community Liaison and works closely with the Community Immunization Program to ensure that community needs are identified and met.  “We want to figure out how we can help you, instead of just enforce” Melissa says.

Melissa’s work includes a variety of tasks.  One project that she helps coordinate are the flu clinics for uninsured, underserved adult populations.  Melissa works with community partners to hold successful flu clinics for Multnomah County residents who would not otherwise have access to flu vaccine. This past flu season, more than  500 doses were administered at these flu clinics.   Some of Melissa’s work also involves liaising with community partner organizations that serve Oregon’s refugee population. Over 80 percent of the refugee population in Oregon live in Multnomah County and receive their initial health screenings and immunization services from the county. 

School Exemptions

Multnomah County has among the highest kindergarten  nonmedical exemption rates in Oregon (9.6 percent for the 2013-14 school year). The Community Immunization Program applied for and received a NACCHO grant to develop vaccine education materials to educate parents about the benefits of immunization. These are available on the  CIP website at: under the “Vaccine Information” tab. They have also created a pamphlet for providers on how to communicate with vaccine hesitant parents.  For a copy of this pamphlet, please email Ginni directly at  In addition to the work that all the Health Department clinics do to increase childhood immunization rates throughout the year, the CIP hosts several immunization clinics in the community in February, to help keep kids in school. 

Rewarding Work

It’s evident that Ginni and Melissa enjoy serving the community. They shared some of their favorite things about their jobs.  “Working with diverse populations is an interesting aspect of my job” says Ginni. Melissa adds that it is a good feeling “knowing the work you are doing matters and is preventing disease.”

Morrow County

Introduction to Morrow County Immunization Program

Morrow County is located in Eastern Oregon, flanked by the Columbia River Gorge to the North and the Blue Mountains to the South. Just under 12,000 residents live among its gently rolling plains and broad plateaus. The immunization program serves the residents of this rural county out of its two offices located in Heppner and Boardman. 

WIC Clinic Partnership

Morrow County Immunization Program staff, Sheree Smith and Vickie Turrell, were looking for an opportunity to increase their infant immunization rates. They decided to partner with the WIC program to provide screening and immunizations to WIC clinic participants. Although the county doesn’t have its own WIC clinic, they used this as an opportunity to build a relationship with the Umatilla Morrow Headstart and WIC Program.  This partnership has been a success. Not only do they reach more infants through WIC, but they offer to screen and immunize anyone who accompanies the kids to the WIC clinic.  This partnership helped kids and their caregivers get timely vaccines, meeting an important need in the community.

Community Outreach

The Morrow County Immunization Program staff tends to keep their boots on the ground with a variety of community outreach projects. They are working on increasing adult immunization rates by holding clinics at local plants and other businesses throughout the county. They are also striving to decrease school exclusion rates for 7th graders by hosting clinics at school registration. Sheree attributes the program’s success to its abundant presence in the community. “We have a lot of visibility,” she says.  

Sheree’s and Vickie’s passion for their work is apparent. The people they serve are ready for their visits and they are ready to serve them “We love what we do!” they both explain.

Although the communities in Morrow and Multnomah County have different needs, the immunization program staff for both counties are committed to serving their communities in the best way possible, through service provision, partnerships, and community outreach.

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