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Promotoras, Politics and Physician Education: Collaborative Immunization Efforts at the US-Mexico Border. San Diego Immunization Branch/ Binational Immunization Initiative. The Immunization Branch and the Binational Immunization Initiative. The County of San Diego Immunization Branch (SDIB)
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Promotoras, Politics and Physician Education: Collaborative Immunization Efforts at the US-Mexico Border San Diego Immunization Branch/ Binational Immunization Initiative
The Immunization Branch and the Binational Immunization Initiative • The County of San Diego Immunization Branch (SDIB) • Clinical Services/Vaccine Preventable Disease Control • Community Outreach/Education • Surveillance and Community Assessment • Program/Contract Management • Provider Services • San Diego Regional Immunization Registry • Special Populations/Inter and Intra-Agency Collaborations
Why the BII? • Geography and epidemiology • San Diego/Tijuana --- busiest international crossing in the world • 80,000 daily, many are regular crossers • Development of collaborative efforts • The Border Immunization Initiative (BII) • Binational Immunization Guide • Migrant Resources Calendar • Establishment of binational working group • NIIW/VWA 2004
Development • Established 2001 • Collaboration of immunization organizations from both sides of the border • Projects developed to • Share messages • Improve communication • Promote understanding of issues between systems
Audiences/Partnerships • Agencies and healthcare organizations providing services to Latino populations and to binational children • Those who may need to understand and interpret immunization records, messages and policies of the Mexican/US immunization systems
Populations • Public Health Centers • WIC Programs • Community Health Centers/FQHC • Schools/Child Care Centers • Community-based organizations • Private providers and health plans
How did it start? • Need recognized • Joint meetings to address issues • Initial projects • Binational Immunization Guide • Promotora training • Including use of the Guide • Training for school and child care staff • Community-based organizations
Other Activities • VWA a CDC priority • Assignment of a Public Health Advisor to San Diego Immunization Branch • Continuing collaboration with Tijuana public health officials for past several years • Binational immunization education • Coordination of immunization messages • Development/revision of Binational Immunization Guide • Vaccination Week in the Americas/Binational Health Weeks
Vaccination Week in the Americas • 2004 • Physicians’ Forums in San Diego and Tijuana • Media events in both cities • Head Start and Mexican org • County Board of Supervisors • Proclamation • Involvement in media event • 2005 • Physicians’ Forum in San Diego • Mexican physicians invited • San Diego media event • MA training at border/Binational Immunization Guide • 2006 . . .
National Health Cards Cartillas Nacionales de Salud
Mexico’s National Immunization Cards Childhood/ Adolescent Immunization Record Women’s Health Card Men’s Health Card Senior’s Health Card
Mexico’s Immunization Cards • Government-issued documents • Established by presidential decree on September 25, 1978. • Created to support the national health system and to document efforts of National Health Weeks (vaccination weeks) • Multiple agencies involved in their national distribution
Immunization Tracking Systems PROVAC • Computerized program to capture and analyze immunization information
National Health Weeks • February • May • October Activities • Ceremonies • Door-Door • Schools • Public Health Clinics • Media • Ceremonies • Door-Door • Schools • Public Health Clinics • Media • Ceremonies • Door-Door • Schools • Public Health Clinics • Media • Ceremonies • Schools • Public Health Clinics • Media
Activities • Ceremonies • Door-to-Door • Schools • Public Health Clinics • Media
Basic Immunization Schedule • Based on 10 antigens contained in 4 vaccines: • SABIN - Polio • BCG - TB • PENTAVALENTE - DTP/Hep B/IPV • TRIPLE VIRAL - MMR
Introduction of New Vaccines 1998Measles MMR 1999DPT Pentavalente 2000 Anti influeza 2006 PCV-7
Binational Immunization Guide • Originally developed in 2001 • Evaluation by users in San Diego and Tijuana • Continuing demand • Redesigned and revised/updated in 2005 • 2 versions • California to Mexico • Mexico to California
Next steps. . . • Continuing and enhanced relationships with Tijuana public health immunization • Ability to share patient information as needed to ensure appropriate immunization protection for children in the Border region • Coordination of immunization messages and efforts when appropriate • Sharing of training and physician education opportunities
For more information: Kathe Gustafson, MPHImmunization CoordinatorSan Diego HHSA Immunization Program3851 Rosecrans St. P.O. Box 85222, MS P511BSan Diego, CA 92186-5222(619) 692-5760Claudia AguiluzCDC Public Health AdvisorSan Diego HHSA Immunization Program3851 Rosecrans St. P.O. Box 85222, MS P511BSan Diego, CA 92186-5222(619) 692-5530