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A Dose of Reality: Texans Stand Up for Immunizations

A Dose of Reality: Texans Stand Up for Immunizations. Nidhi M. Nakra, M.P.H. Director of Education and Advocacy The Immunization Partnership Texas Vaccines for Children Conference May 29, 2013 ~ Odessa, Texas. The Immunization Partnership Who are we?.

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A Dose of Reality: Texans Stand Up for Immunizations

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  1. A Dose of Reality:Texans Stand Up for Immunizations Nidhi M. Nakra, M.P.H. Director of Education and Advocacy The Immunization Partnership Texas Vaccines for Children Conference May 29, 2013 ~ Odessa, Texas

  2. The Immunization PartnershipWho are we? Statewide partnership committed to the eradication of VPDs through education, advocacy, and the promotion of immunization best practices. • Advocacy and Stakeholder Engagement • Building Coalitions across Texas (BCaT) • Immunization Champions • Community Immunity • Provider Education

  3. Community Immunity Activity

  4. BackgroundBenefit of Stakeholder Engagement Exchange informational need through informal dialogue Communicate through legislative/grassroots efforts Identify opportunities and evaluate policy options

  5. BackgroundStakeholderAssessments

  6. Legislative Reforms 2009 ImmTrac and Adults (SB 346) Sen. Jane Nelson and Rep. Lois Kolkhorst Adults may now enter their information into the state immunization registry, ImmTrac. ImmTrac and Interstate Data Sharing (SB 347) Sen. Jane Nelson and Rep. Lois Kolkhorst Allows Texas to share information with other state if there is an emergency in Texas that forces Texans to surrounding states. Meningitis Vaccination for College Students (HB 4189) Rep. Patrick Rose and Sen. Kirk Watson Effective January 2010, any student entering a dormitory for the first time must have the meningitis vaccine.

  7. Legislative Reforms 2011 Meningitis Vaccination for College Students (SB 1107) Sen. Wendy Davis and Rep. Charlie Howard The Jamie Schanbaum and Nicolis Williams Act requires all college students to be vaccinated against meningitis prior to school entry. Pertussis Education for New Parents (HB 3336) Rep. Garnet Coleman and Sen. Bob Deuell Parents of newborn children will receive information about the dangers of pertussis and about the importance of vaccinations. Healthcare Worker Vaccination (SB 7) Sen. Jane Nelson and Rep. John Zerwas Ensures that all Texas healthcare facilities have a policy in place regarding healthcare worker vaccination.  

  8. 2012 Stakeholder AssessmentTown Hall Meetings Location of Immunization Stakeholder Meetings, 2012

  9. 2012 Stakeholder AssessmentTown Hall Meetings • Review immunization topics on the national and state front • Discuss immunization challenges and identify priorities • Share advocacy strategies and techniques

  10. 2012 Stakeholder AssessmentWeb-Based Survey Respondents • 217 respondents • 46 towns and cities across Texas • 37% attended at least one stakeholder meeting Survey Topics • Barriers to increasing immunization rates in Texas • Potential enhancements to the immunization registry • Meningitis and human papilloma virus (HPV) vaccines • Immunization funding • Level of support for potential legislation

  11. Summary of Recommendations • Restore funding for immunizations and safety net programs. • Enhance the state immunization registry, ImmTrac, with specific features. • Provide outreach and education to people who are vaccine hesitant. • Reduce the number of vaccine exemptions that are claimed due to reasons of conscience. • Improve immunization uptake among childcare providers through education and facility-based vaccination policies. • Decrease incidence of bacterial meningitis by improving access to meningitis vaccine for college students. • Promote strategies to reduce pertussis (whooping cough) incidence.

  12. Stakeholder Assessment FindingsImmunization Funding and Policies

  13. “We turn away approximately 80-100 clients/month due to the eligibility changes. Many people regard us as the experts in immunizations and prefer to receive their vaccines from us.” - TVFC Coordinator “Many parents say their primary care providers don’t carry the vaccines and they can’t afford to pay the private vaccine prices. So, I don’t know if they are finding physicians who do carry the vaccines or if they are just delaying getting vaccinated.”- Stakeholder, Wichita Falls “The new, more restrictive eligibility requirements have increased staff time necessary to screen patients and especially to explain to former patients why we can’t serve them anymore.” - Employee, public health dept

  14. “Health Science applicants are having a difficult time trying to find low cost vaccines, and financial aid doesn’t pay for them.” -Employee, Community College, Houston “We live in a very rural area of south Texas. Adults are not receiving the vaccinations they need because of the distance they have to drive to receive them.” -Employee, public health department “Most adults we hear from say that they will just give up on fighting or chasing their insurance company. Many tell us that they will not bother with immunizations anymore. This is especially true of our minority and high-risk populations.” -Director, public health department

  15. Stakeholder Assessment FindingsEnhancements to ImmTrac

  16. Stakeholder Assessment FindingsEnhancements to ImmTrac Extent to which Current Process of Obtaining Consent for ImmTrac Contributes to the Following Issues, 2012

  17. Stakeholder Assessment FindingsEnhancements to ImmTrac ImmTrac Users Rank Five Categories of Enhancements to ImmTrac, 2012

  18. Stakeholder Assessment FindingsEnhancements to ImmTrac Childhood Screening Features Desired by ImmTrac Users, 2012

  19. Stakeholder Assessment FindingsProvider Utilization of ImmTrac Percentage of Respondents Who Believe the Following Perceptions Among Providers are Barriers to Using ImmTrac, 2012

  20. Stakeholder Assessment FindingsProvider Utilization of ImmTrac Percentage of Respondents Who Believe the Following are Barriers to Physician Utilization of ImmTrac, 2012

  21. Stakeholder Assessment FindingsVaccine Hesitancy

  22. Stakeholder Assessment FindingsVaccine Hesitancy • 89% believe that “misinformation or lack of knowledge about vaccines” is a “somewhat” or “very important” barrier to increasing immunization rates “Everybody has car insurance…getting immunized is like buying insurance to protect the body against disease.” - Stakeholder, Austin

  23. Stakeholder Assessment FindingsVaccine Exemptions

  24. Stakeholder Assessment FindingsVaccine Exemptions

  25. Stakeholder Assessment FindingsVaccine Exemptions Percentage of K-12th Grade Students Invoking the Personal Belief Exemption, Texas, 2003 - 2012

  26. Stakeholder Assessment FindingsVaccine Exemptions The exemption process in Texas should also include a written verification that the person has been counseled by a healthcare provider on the risks and benefits of vaccination

  27. Stakeholder Assessment FindingsImmunization Uptake Among Childcare Providers

  28. Stakeholder Assessment FindingsImmunization Uptake Among Childcare Providers Individuals working at childcare centers should be required to show proof that they have been vaccinated against certain VPDs.

  29. Stakeholder Assessment FindingsBacterial Meningitis

  30. Stakeholder Assessment FindingsBacterial Meningitis Legislation The New Law Results in More College Students Receiving Preventive Health Checks

  31. Stakeholder Assessment FindingsBacterial Meningitis Legislation Extent to Which the Following Issues Make It More Challenging for College Students to Get their Meningococcal Vaccination, 2012

  32. Stakeholder Assessment FindingsBacterial Meningitis Legislation If proposed that the age range for meningococcal vaccination be decreased so that college students through age 21 are required to get immunized, how likely would you be to support this proposal?

  33. Stakeholder Assessment FindingsBacterial Meningitis Legislation If proposed to make the booster dose a requirement in Texas, how likely would you be to support such a measure?

  34. Stakeholder Assessment FindingsPertussis

  35. Pertussis

  36. Legislative Proposals 2013

  37. Legislative Proposals 2013 • SB 40: Shift to opt-out immunization registry • HB 771: Retain registry information after age 18 years • HB 1310: Allow a physician medical practice to exclude the cost paid for vaccines from its taxable revenue. • HB 2711/SB 1054: Requires proof of a meningococcal vaccination or booster dose. • HB 1611: Relating to the date by which students must receive a vaccination against bacterial meningitis. • HB 2709: Relating to the establishment of a state plan for bacterial pneumonia education and prevention.

  38. Next Steps - Become an Advocate! • Building Coalition across Texas • Site assessments and strategic planning • Webinars, advocacy/education resources • 2014 Stakeholder Meetings and Survey • Biennial publication • 2014 Immunization Summit (fall) • 2015 Legislative Session

  39. How Big is Your Sphere of Influence?

  40. Thank You! • Nidhi M. Nakra, MPH • Director of Education and Advocacy • 51-219-4018 • nnakra@immunizeUSA.org

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