chris finley and karen halverson ensuring herd immunity immunization rules for schools and child...
TRANSCRIPT
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Chris Finley and Karen Halverson
Ensuring Herd ImmunityImmunization Rules for Schools and Child Care
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Today’s objectives
Rationale for immunization regulations
Reporting requirements
Statewide variations in rates
Addressing challenges
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State Immunization Rules
Prevent disease transmission
Reduce risk in group settings
Support herd immunity
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Herd Immunity
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Measles at Vermont’s borders
Massachusetts, New York and New Hampshire
50 cases 1/1/11-10/8/11
Only religious and medical exemptions allowed
No philosophic exemptions
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Measles at Vermont’s borders
Quebec
745 cases 4/3/11 -10/5/11
11% of cases hospitalized
No vaccination requirements for school
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Development of Immunization Rules
Specific state statutes
Rules provide details for implementation
Defined process for passage of rules
Opportunity for public input Reviewed by two committees
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Vermont’s Immunization Rules
Immunizations required for enrollment
Application in child care and school settings
Annual reporting period
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Vermont Recommended Child and Teen Vaccination Schedule
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Child Care Requirements
Who do the rules apply to?
How are these different than school rules?
Who completes child care reports?
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Information for Child Care Providers Put in pictures of 2 brochures and manual
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School Requirements
Align with Advisory Committee on Immunization Practices (ACIP) recommendations
Allow for exemptions
Provisional admittance limit of one year
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Vermont Kindergarten Immunization Exemptions and Provisional Status
0%
2%
4%
6%
8%
10%
12%
14%
'10-11'09-10'08-09'07-08'06-07'05-06'04-05'03-04'02-03'01-02'00-01
Year of Enrollment
Per
cent
of S
tude
nts
Sur
veye
d
philosophic exemptions (%)provisional status (%)
Varicella (2 doses) and hepatitis B requirement added to school rules in 2008.
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Unimmunized KindergartenersVermont 2010-2011
1% 0.2%
5%
10.7%
0%
2%
4%
6%
8%
10%
12%
medicalexemptions (%)
religiousexemptions (%)
philosophicexemptions (%)
provisionalstatus (%)
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Kindergarten data 2010-11
Percent of Vermont Schools with Provisional Admittance
36%28% 31%
5%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Fully compliant Low provisional High provisional Very High provisional
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Measles outbreak risk in Vermont
Herd immunity threshold for measles:95%
2010-11 kindergarteners with 2 doses MMR:
90.9%
Schools with coverage below 95%:136
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School Site Visits January - May 2011
Pilot visits to selected schools by Immunization Program staff
Sept 2011 - May 2012 Site visits to all schools conducted by District Office school liaisons
Sept 2011 - May2012 Quality improvement project visits for 15 schools conducted by VCHIP/VDH
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Increasing Compliance with Vermont Vaccine Requirements
Utilize electronic data sources VT Immunization Registry
school health software programs
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Increasing Compliance with Vermont Vaccine Requirements
Outreach
at enrollment
before vacation and holiday breaks
newsletters, websites, PTO
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Immunization Program Support
Vermont Immunization Program1-800-640-4374
District Office staffSchool liaisonImmunization Designee