Adult and Adolescent Immunization Program TISWG Presentation DSHS

Adult and Adolescent Immunization Program TISWG Presentation DSHS Vision: A Healthy Texas Mission: To improve health and well-being in Texas

Follow Up From Last Meeting n Discussion: Clarification, Strengths and Barriers n Top Points for Clarification: n Different Strategies for Different Vaccines and Priority Age Groups. n National Rankings n Strength of Adult Safety Net and Insurance Coverage

Follow Up From Last Meeting n Discussion: Clarification, Strengths and Barriers n Top Points for Strengths: n TISWG – Strong Partnerships n H 1 N 1 Awareness n Medicare coverage, Immtrac as a lifelong registry and vaccine availability

Follow Up From Last Meeting n Discussion: Clarification, Strengths and Barriers n Top Points for Barriers: n Education: Adults do not know or understand schedule n Benefits: Employers don’t pay n High fees, misinformation on the internet, adults need reminders, providers don’t ask adults about vaccination status, doctors need education and adults don’t visit providers on a consistent basis.

Adult Immunization Strategic Plan Background n Request by Dr. Lakey / Purpose Table of Contents I. Executive Summary II. Adult Immunizations in Texas III. Current Situation a. Vision and Mission b. Background c. Partnerships d. Gaps in Adult Immunization Services

Background V. Path to goals and objectives a. Legislation VI. Implementation Program a. Systems approach b. Business plan VII. Looking Forward: Adult Immunizations in the Years to Come

Main Message from the Executive Summary n Insurance: Lack of VFC style adult program and health care reform n Studies: Prevention is more cost effective than VPD management n Barriers to immunization that adults face include inadequate/lack of insurance, poor preventive care, vaccine misinformation and incomplete access to and knowledge about the adult vaccination schedule.

Main Message from the section Adult Immunizations in Texas n New ACIP Recommendations since 2005 n We must raise adult coverage levels n Lack of data: HPV, Zoster/Shingles and Influenza are not reportable conditions. n Presentation of the little data we have on Varicella, Zoster/Shingles, Meningococcal and Pneumococcal. n Pertussis n Success with Hep A and Hep B

Coverage Levels

Success with Hep A Data from DSHS

Success with Hep B Data from DSHS

Main Message from the Section on Current Situation n Vision and Mission n Background n Partnerships n Gaps in Adult Immunization Services n Vaccines n Access to vaccine n Insurance coverage n Making prevention a priority

Main Message from the Section on Path to Goals and Objectives Strategic Directions 1. 2. 3. 4. 5. 6. Promote the use of Imm. Trac, the statewide immunization registry Promote the use of reminder/recall where appropriate, and encourage all providers to conduct an initial screening for all new adult patients to determine if immunizations are needed Public education Provider education Promote the medical home Work with stakeholders to improve the strategies mentioned above and to work towards filling gaps within the adult, statewide immunization system

Main Message from the Section on Path to Goals and Objectives Goal: Improve adult immunization levels through specific objectives and activities. Legislation: SB 40, Texas Administrative Code, Chapter 161 of the Health & Safety Code and the Jamie Schanbaum Act

Main Message from the Section on Implementation Program Immunization Branch and Stakeholder Flow Chart

Texas Adult Immunization System Organizational. The IB will work with organizational partners to increase adult immunization rates. The IB will strengthen the TISWG to identify and include non traditional partners. The IB will support local stakeholder groups and encourage policies and practices that support preventive care. The IB will work with organizational partner to identify gaps in the adult immunization system and close those gaps. Individual. The IB will continue to raise awareness about the need for adult immunizations and address barriers to immunizations. The IB will focus efforts in conjunction with the IDCU to identify source and baseline data for Texas-specific adult VPD stats. POLICY Texas Legislature CDC COMMUNITY Alternative Vaccination Sites Schools Health Plans ORGANIZATIONAL Community Vaccinator s TISWG State/local health departments Medical Associations Long term care facilities Hospital s Prisons TALHO INTERPERSONAL Provider/Physician s Health Care Workers Family INDIVIDUAL Friend s Policy. The IB will continue to work with the CDC to ensure that federal grant requirements target meaningful activities that support the national and statewide immunization system. The IB will support efforts to influence local, state, community, state and regional or national legislation related to immunizations. Support legislative changes for mandatory vaccination of health care workers. Work with insurance health plans to Medicare/Medica include adult id vaccine coverage and continue to seek Communityadditional fundswith to sustain the adult The federal IB will work communities, safety-net workplaces, and neighborhoods in expansion for non-traditional vaccination sites increasing public awareness about adult (i. e. immunizations by continuing media FQHCs andand family Planning campaigns, educating the. Clinics). public and providers about the benefits of adult vaccinations. The IB will work with communities to increase vaccine coverage levels for adults. The IB will promote the medical home and identify health care provider sites serving adult populations, but unlikely to vaccinate. Work with those alternative vaccination sites and community FQHCs vaccinators to provide adult immunizations. Interpersonal. The IB will encourage health-care FPCs providers to make vaccines a STD/HIV priority. The IB will promote the /AIDS concept of a medical home, promote alternative vaccination Clinics sites when a medical home does not exist, educate patients about adult immunizations, and inform population about resources to pay for immunizations.

Main Message from the Section on Implementation Program Business Plan for Adult Immunizations Objectives 1. Work with stakeholders to fill in gaps within the adult, statewide immunization system 2. 1 Promote use of reminder/recall 2. 2 Encourage all providers to conduct an initial screening for all new adult patients to determine if immunizations are needed. Encourage healthcare providers to promote the medical home. 2. 3 Provide education to the public and adults. Encourage healthcare providers to promote Imm. Trac.

Main Message from the Section on Looking Forward: Adult Immunizations in the Years to Come n Health insurance for all n Medicare n Revisit the “no one gets turned away” policy n Pharmacies and Private Providers

Vaccinate for Life! Presented by: Tristán del Canto Adolescent/Adult Immunization Coordinator Assessment, Compliance & Evaluation Immunization Branch Department of State Health Services tristan. delcanto@dshs. state. tx. us Office: (512) 458 -7111, ext. 3948