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Monthly Newsletter - August 2016
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9/19/16 - Voices for Vaccines: Vaccine Refusal Conference Call with Dr. Jennifer Reich-
Register Here
Public Health Nursing
Baby Showers
9/10/16 - Sweetwater County Community Nursing-Rock Springs
9/17/16 - Fremont County Public Health
TBD - Carbon County
Public Health, Rawlins
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Flu Clinics 2016-2017
To post your upcoming fluclinics to the Immunization website, please click
HERE
to fill out an online form to advertise your flu clinics.
EXTRA! EXTRA Read All About It!
Vaccine preventable diseases and vaccines that is! We currently have copies of the 13
th
Edition Epidemiology and Prevention of Vaccine-Preventable Disease (also lovingly known as the Pink Book) available at no cost. This is one of the best resources around for all things related to immunizations. Please contact Val at
val.knepp@wyo.gov
to receive your free copy.
Want to Request a Copy of an Immunization Record?
If you need a copy of an immunization record that has been reported to our registry, please click
HERE
to find out how.
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Reflections-Immunization Advocates
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Reflection of a Life with Vaccinations
Maryalice Gulino, RN, BSN, Public Health Nurse
Albany County Public Health
I have just turned 59 years old and have spent 23 years of that in a county public health immunization specialty program. During that time, I have gone through many life roles; being a new nurse but not yet a mom; a nurse who had tried to successfully become pregnant for longer than I thought it would take (along with a miscarriage along the way); finally a pregnant nurse; then a new mom right when all the "anti-vax" movement began with the anti-DPT, and then a mom whose children were growing during the time when there was literally an explosion of vaccines that could now protect them against terrible diseases.
<<read more>>
It All Started With a Poster
Val Knepp, RN, Clinical & AFIX Specialist
An interesting thing happened the other day. My almost 12 year old daughter came to my office for a quick visit. She saw the HPV Cancer Prevention poster hanging on my cabinet and started asking me questions about it, like what HPV was and what kinds of cancer it causes. I could see the concern on her face as we continued to talk about it. Then she started asking about the vaccine, because she noticed that the ages listed on the poster were 11-12 years. We talked about what the vaccine does and that there are 3 doses. Then came the most important question of all; "So, do I need to get the vaccine?" she asked. I replied, "Well, what do you think?" Her reply, "You know I hate shots, but I don't want to get cancer, so I should get the vaccine!" This poster sparked a great conversation with my adolescent and it can do the same for the adolescents and parents in your office or school!
Click
HERE to download this conversation starting poster and check out this cool video ad about HPVL
www.hpvtvad.com.
Using these great tools to promote HPV vaccine could spark a conversation and might just save a life!
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A Look Ahead: The New Immunization Assessment
Val Knepp, RN, Clinical & AFIX Specialist
If you are a School Nurse then you have likely completed, or at least heard of, the Immunization Assessment. The Assessment has evolved over time from being a paper survey that was mailed out to each school to a survey format over the past couple of years. It was sent out via an email link in mid February to mid March and was due to be completed by mid to late April. It has always collected data on kindergarten and 7th grade students.
After reviewing the Immunization Rules it was discovered that the Assessment had not been delivered correctly in the past. According to the Rules and Regulations for Required Immunizations, which complies with Wyoming Statute § 21-4-309, the Wyoming Department of Health has authority to conduct an annual audit of immunization status of any child enrolled in school. In Section 8 it goes on to say that a report of immunization status of pupils in every school and child caring facility shall be sent once a year to the Wyoming Department of Health and that data shall be submitted no later than November 1 of each year.
<<read more>>
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Influenza Products for the 2016-17 Season
Kristy Westfall, VFC Coordinator
The 2016-17 Influenza Season is upon us! Earlier this year the Advisory Committee on Immunization Practices (ACIP) recommended that providers not use Flumist® during the 2016-17 Influenza Season. Any time the ACIP makes changes to recommendations, the Director of the Centers for Disease Control and Prevention (CDC) must review and approve the new recommendation. At this time the CDC has not yet updated their resources for the 2016-17 Influenza Season. The Immunization Action Coalition (IAC) has released a list of available influenza vaccine presentations that has been reviewed by the CDC.
WyIR User Access - changes to process starting October 1, 2016
John P. Anderson, MA WyIR Program Coordinator
A recent review of the WyIR Rules revealed that the process we enabled to provide more local control of user management, where WyIR Facility Contacts were given the authority to manage users for their own sites, is not in compliance with the Rules. Within the WyIR Rules and Regulations, it presents the following regarding Section 7 Access Levels:
WyIR access shall be role based. Authorized Users shall be assigned an appropriate Access Level by the Immunization Section. Role-based access shall include:
- Administrator Access: The Administrator Access Level or her designee shall have the ability to activate new accounts for Authorized Users based on their roles in an organization as defined by the organizational representative.... Individuals who have Administrator Access shall be limited to employees of the Wyoming Department of Health who are responsible for supporting and maintaining the WyIR.
As our understanding of the rules has been clarified, we will now coordinate the management of users accounts in the WyIR. Guidance will be presented shortly to WyIR Facility Contacts about the updated user management process. We anticipate reaching out to each site locally and providing a list of active users for their site, and have the WyIR Facility Contact verify the appropriate access level for all of the active users for a facility, and then updating their permissions accordingly. Thank you for assisting the WyIR staff as we transition the management of users back "in house," as specified in the current WyIR Rules.
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ACIP Update-June 2016
Val Knepp, RN, Clinical & AFIX Specialist
The Advisory Committee on Immunization Practices (ACIP) met on June 22nd and 23rd in Atlanta, Georgia. Listed below are the highlights from the meeting.
On April 14, 2016 the FDA approved a 2 dose schedule for Trumenba® meningococcal vaccine. The second dose should be given 6 months after the first. ACIP has not changed their recommendation. There are instances where the vaccine manufacturer will update their dosing schedule and it does not align with ACIP. Providers can choose to give a vaccine following the manufacturer's schedule, but that would be considered an "off label" use to ACIP. We at the Immunization Program always encourage providers to follow ACIP recommendations.
Use of Meningococcal conjugate vaccines (MCV4) in people infected with HIV was voted on and approved for routine use in this group, for those 2 months of age and older.
H1N1 was once again the predominant strain that caused most flu illness in the 2015-2016 flu season.
<<read more>>
2016-2017 Influenza Vaccine Information Statements
LaChel May, Compliance Specialist, CPM
Influenza Vaccine Information Statements (VIS) are no longer updated annually. The edition dated 8/7/2015 should be used for the current flu season.The flu season dates (i.e., 2015-16) are no longer displayed at the top of flu VIS either. Until there is a significant change in flu recommendations that will require changing the VIS, please continue to use the 8/7/2015 version. You can locate the Influenza Vaccine Information Statement, along with other current and up to date Vaccine Information Statements, by visiting
the Vaccine Information Statements webpage of the CDC website.
Temperatures Outside Can Affect Temperatures Inside
LaChel May, CPM, Compliance Specialist
Did you know that the temperature outside can affect the temperatures of your vaccine storage unit? When temperatures outside increase or decrease, units that are not specifically designed for vaccine storage (i.e. household/commercial grade units) become reactionary to external temperature changes. When inside temperatures change due to running the air conditioner or heater or other factors such as the unit being near an outside wall or window, your storage unit could see a temperature change. Vaccine storage units that are exposed to external changes begin to work harder making it difficult for the unit to maintain stable, in-range temperatures. Please be aware that when the temperature outside fluctuates, the temperatures of vaccine storage units may too. Monitoring vaccine storage units closely when the temperatures outside change can help prevent temperature excursions.
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2016-17 VFC Influenza Guidelines
Kristy Westfall, VFC Coordinator
The 2016-17 Influenza Season is upon us and we will soon be opening the VFC flu order set! We just wanted to remind Public Vaccine Program providers about a few key things this season:
1. Public influenza vaccine is ONLY available through the VFC Program.
2. WyVIP, VUA, and AHV-eligible patients may not receive publicly supplied flu
vaccine.
3. All VFC-enrolled providers must carry both VFC and private flu vaccine
throughout the 2016-2017 Flu Season,
4. Providers cannot charge patients for publicly supplied flu vaccine
5. Only an administration fee of no more than $21.72 may be charged for publicly supplied flu vaccine.
6. If a VFC-eligible patient is unable to pay the administration fee, they cannot be
Breaking Away From Paper: New Vaccine Return Process
Lisa Sara, Provider Support Specialist
The Immunization Program has been gradually moving away from paper and working hard on integrating the Wyoming Immunization Registry (WyIR) to simplify reporting requirements for the Public Vaccine Programs.
In an effort to continue the break from paper, Vaccine Returns will now be processed in the WyIR by each facility's assigned Vaccine Coordinators, which will eliminate the use of the Vaccine Return Form. Please note that only the processing portion has changed; the return policies remain the same.
<<read more>>
Wyoming Welcomes a New Compliance Specialist
Kristy Westfall, VFC Coordinator
The Compliance Specialist position within the Immunization Program was recently vacated when I took on the role of VFC Coordinator. As a Compliance Specialist for over three years, I wanted to make sure that only the most qualified person filled the position. The Compliance Specialist is responsible for conducting site visits with Public Vaccine Program providers, understanding vaccine storage and handling best practices, providing education and resources to providers, and so much more.
I am excited to welcome Lisa Sara as the new Compliance Specialist for the Wyoming Immunization Program! She is going to do great things in this position and will continue providing outstanding customer service and support to the immunization providers in Wyoming. As most of you know, Lisa was previously the Provider Support Specialist and is already familiar with the work done by the Immunization Program and the Public Vaccine Programs.
Please join me in congratulating Lisa on her great accomplishment and for her commitment to Bringing Immunity to Every Community!
Data Logger Guidance
LaChel May, CPM, Compliance Specialist
This year many providers are having to send off data loggers for recalibration. Regardless of which company the data loggers are sent to for recalibration, please remember to follow the manufacturer's specific guidelines when returning the data logger to the vaccine storage unit. The Wyoming Immunization Program provides step-by-step guidance on selecting and using a data logger thermometer to monitor temperatures of vaccine inventory.
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Wyoming Immunization Registry (WyIR)
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WyIR Vaccine Type Cheat Sheet - updated
John Anderson, MA, WyIR Coordinator
Each year, as the vaccine presentations are updated by the manufacturers, we provide a form that can help translate how the vaccines should be entered into the WyIR - the WyIR Vaccine Type Cheat Sheet. In coordination with the Clinical & AFIX Specialist and the Vaccine Program, the latest was developed and posted on the WyIR page of the Immunization Unit's webpage. Please utilize the sheet to ensure that all your private stock is recorded accurately in the WyIR.
WIC is Connected!
John Anderson, MA, WyIR Coordinator
Earlier this month, as a part of the CDC's recommended activities of Immunization Information Systems (IIS), the Women, Infants, and Children (WIC) Program gained access to the WyIR in order to provide a record of recommended vaccines that are "due now" or "past due" to their clients. Similar processes have been in place in other states, and have helped increase immunization rates tremendously. If a parent arrives in your office with a patient's forecast printed off, it may be the result of WIC efforts. We look forward to a successful relationship with their offices, and will provide updates when available regarding the results of their efforts.
Transition from Direct Data Entry to Electronic Exchange
John Anderson, MA, WyIR Coordinator
Historically, the overwhelming majority of data entered into the WyIR has been hand entered by users logging into the WyIR and entering the information directly into the system. While there has been a few interfaces sending data to the WyIR electronically for some time (i.e., Indian Health Service and a few adopters of Electronic Health Record systems), the interest in connecting a provider's database and the WyIR did not pic up steam until Meaningful Use incentives began a few years back. In recent reports, it is noted that the primary method of reporting data to the WyIR is very close to transitioning to a majority of records being updated via electronic data exchange rather than direct data entry.
For some, this is an exciting time, since most users now don't have to chart in multiple locations, but rather just their system. And for some users involved in the exchange process, it is not as exciting initially for others, as it is a new process that has to be understood before fully embracing the benefits. Fortunately for Wyoming, our vendor has helped develop training and guidance for facilities transitioning to the data exchange process to meet Meaningful Use. While we are aware of some of the issues that have presented now that providers are connected, we are working towards improving the connection process so as providers can get access to the information contained within the WyIR as close to "real-time" as possible. We look forward to continuing our progress at exchanging data, and appreciate the efforts made by staff at each facility in ensuring that your site will get the immunization data for their patient when it is needed.
WyIR Post Version Upgrade - Outstanding System Bugs
John Anderson, MA, WyIR Coordinator
In most version upgrades, there are improved features, as well as, system bugs that may appear in the real world that were not present in the testing scenarios. In the August newsletter, we mentioned the improvements; now that we have some time under our belt in this version, a few issues have presented that most users need to be aware of - here they are, presented as titled on our vendor's Help Desk:
HDWY-1039 Vaccines posted to incorrect patient
Following the V5.16.1.5 version upgrade that occurred before August 1, 2016, users again reported that data from non-patients was being placed on their patient's record. A showstopper ticket was created on our vendor's help desk, which leads to a 24 hour response time from the vendor. The vendor re-ran the ambiguous ID correction script that was previously used in the last version upgrade, and they have stated that the script has fixed all the records in question. If you are aware of records that appear to be incorrect, please contact us as soon as possible so we can work towards ensuring data integrity within the WyIR.
HDWY-1036 Patient Eligibility on Demographic screen defaults to Adult State
Almost immediately after the upgrade, users started reporting that the demographics page was changed for all their patients to display Adult State as their eligibility. If possible, update the field after the patient presents to the office for an assessment. Our vendor is working towards a solution, as it has affected all patients in the WyIR following the version upgrade.
HDWY-1045 Reconciliation: system non-user aggregate reporting only
When a provider reconciles using the reason "System non user aggregate reporting only" which is used by all providers connected via HL7, the changes are not saved. Once submitted or saved, the changes are not applied. Until this issue is resolved, users will need to reconcile using the option of "Administered but not linked to a vaccine."
As usual, if you recognize any other areas of concern please report them to the WyIR Help Desk at
wyir@wyo.gov
.
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School Nurses - Welcome Back!
John Anderson, MA, WyIR Coordinator
As the school year kicks back into gear, students are required to provide proof of immunizations to the school they are attending to be compliant with the immunization requirements outlined in the School Rules. If a parent/guardian is unable to provide an official record of immunization for their child, school nurses may request access to the WyIR in order to view the immunization records contained therein.
Written parent/guardian consent must be obtained prior to accessing student records.
In this latest version of the WyIR, additional permissions have been applied to the accounts of school nurses limiting their access within the WyIR to search/select patients and then print off an official record of immunization when needed for their students. This change is more restrictive to what was provided in earlier versions of the WyIR - now that the system has been updated, we needed to limit access further under our guidance from our HIPAA Compliance Office, as well as the information contained within the rules that pertain to the WyIR.
Under the current Rules and Regulations for the WyIR, school nurses are permitted access to the WyIR "only to assure adequate immunization" so as to "confirm compliance with mandatory immunization requirements." And under our State of Wyoming HIPAA policies, "WDH workforce shall make reasonable efforts to limit such PHI to the information reasonably necessary to accomplish the intended purpose of the use" of the WyIR. Now that the functionality within the WyIR has caught up to the intent of our Rules and Policies, school nurses will now be limited to accessing the information in the WyIR for only the intended purposes - to supply an Official Record of Immunization if one can't be ascertained from the parent/guardian.
An updated School Nurse Guide has been sent via email, as well as posted on the WyIR portion of the Immunization Unit page. School Nurses, thanks again for all you do for our Wyoming children!
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The Flu and You!-Increasing Influenza Vaccination
LaChel May, CPM, Compliance Specialist
CDC offers resources to help employers increase influenza vaccination coverage rates
The Centers for Disease Control and Prevention offers targeted resources for a variety of workplaces to help increase influenza vaccination rates.
Each page includes general information as well as targeted resources for each population.
Related Links
Nurses can now watch the film "Someone You Love: The HPV Epidemic" and get free continuing education credit
IAC Express #1264
"Someone You Love: The HPV Epidemic" is a feature-length documentary that presents the struggles and triumphs of five women whose lives were changed forever by this deadly virus. Directed by Frederic Lumiere and narrated by Vanessa Williams, the film interweaves personal stories with facts about this common and potentially deadly virus. The goal of this project is to raise awareness about HPV and cervical cancer.
The film has been available through the Indiana University School of Medicine, in partnership with the Indiana Immunization Coalition and Lumiere Media, as a free online CME activity worth 1.5 AMA PRA Category 1 Credits for physicians and for 1.5 credit hours (0.15 CEU) for pharmacists and pharmacy techs. Continuing nursing education activity is also now available through the Ohio Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation, for 1.91 Contact Hours.
Physicians, pharmacists, and nurses can all
access more information on the Indiana University Division of Continuing Medical Education website. NOTE: Groups wishing to inquire about sponsoring a screening of this film should contact Lumiere Media
atcheryl@hpvepidemic.com.
American Cancer Society Provides New HPV Resources
Jude Alden, MBA, CPM, Immunization Unit Manager
Recently the Association of Immunization Managers (AIM) shared some great resources provided by the American Cancer Society. We encourage providers to review these resources and implement best practices whenever possible.
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New: CDC Vaccine Storage and Handling Toolkit!
LaChel May, CPM, Compliance Specialist
In June 2016, CDC released an updated version of the Vaccine Storage & Handling Toolkit. The Toolkit is a comprehensive guide for healthcare providers on recommendations and best practices for:
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Managing vaccine inventory and transport
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Storing and preparing vaccine
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Monitoring vaccine temperature
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Using and maintaining storage unit and temperature monitoring equipment
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Preparing for emergency storage, handling, and transport situations
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Developing standard operating procedures for routine and emergency vaccine management and training staff
The 2016 Vaccine Storage and Handling Toolkit reflects an adjustment in CDC's guidance on the Fahrenheit temperature range for storing refrigerated vaccines. The new recommended Fahrenheit temperature range is 36°F to 46°F (previously 35°F to 46°F). The Celsius temperature range (2°C to 8°C) remains unchanged, as stated in all manufacturer package inserts for routinely recommended vaccines.
The 2016 Toolkit has a new design to help healthcare providers find the information they need quickly and easily. The beginning chapters address the three main elements of an effective cold chain: a well-trained staff, reliable storage and temperature monitoring equipment, and accurate vaccine inventory management. The remaining chapters focus on emergency management of vaccine and developing standard operating procedures for routine and emergency storage and handling.
The CDC Vaccine Storage and Handling Toolkit is a necessary and important vaccine storage and handling resource that should be reviewed by all staff who work with immunizations.
Book Release: Calling the Shots: Why Parents Reject Vaccines
Released June 2016, Calling the Shots: Why Parents Reject Vaccines is a book written by Jennifer Reich, an Associate Professor Sociology at the University of Colorado, Denver. She has been studying the phenomenon of vaccine refusal from the perspectives of parents who distrust vaccines and the corporations that make them, as well as the health care providers and policy makers who see them as essential to ensuring community health for more than a decade.
Click
HERE to order your copy today.
Voices for Vaccines will be hosting a conference call on September 19th with Dr. Jennifer Reich.
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1.In what instance is it acceptable to use dry ice to keep vaccines cold during transport? (Answers at the end)
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During emergency situations only when no other options are available to keep the vaccines cold.
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Any time vaccine needs to be transported and it is the only option available for keeping the vaccines cold.
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Never. Dry ice is not acceptable for keeping vaccine cold during any circumstance.
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It is only to be used to transport frozen vaccine, not refrigerated vaccine.
2. What is the due date for completion of the new School Immunization Assessment?
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April 30, 2016
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October 1, 2016
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November 1, 2016
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November 30, 2016
3. How many individuals are subscribed to the Jab & Gab?
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100
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125
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510
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380
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470
1) c 2) c 3) d
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Our next newsletter will be released in September 2016
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WYOMING DEPARTMENT OF HEALTH, IMMUNIZATION UNIT
6101 Yellowstone Road, Suite 420, Cheyenne, WY 82002
307-777-7952 FAX: 307-777-3615
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Copyright © 2016. All Rights Reserved.
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