1. What AAP Chapters Can Do To Improve Immunizations The Immunization Initiative of the Massachusetts Chapter of the Academy of Pediatrics (MCAAP-II) Hadassa Kubat, DSc, MPH Sean Palfrey, MD, FAAP

2. 2 During the last decade, Massachusetts achieved some of the highest rates of infant immunization coverage The MCAAP Immunization Initiative has been a partner in this statewide effort. Background and History Estimated vaccination coverage with 4-3-1-3-3 for children 19-35 months Massachusetts & US, 1995 - 2004 National Immunization Survey, CDC

3. 3 Setting and Population Population ~ 1.600,000 children ≤18 years of age ~ 80,000 births annually ~ 1,800 public and private pediatric practices (this includes peds, FP, IM, CHCs, etc.) Physicians 2627 pediatricians (including subspecialties that do not regularly immunize) 1220 family physicians who may care for children but also care for adults and the elderly ~ one physician per 415 children “Universal Distribution State” Massachusetts Department of Public Health (MDPH) has 5 regional offices that distributes vaccines to distributors and providers. 141 vaccine distribution centers that distribute vaccines to providers. (Boards of Health and VNAs) Massachusetts

4. 4 Our Principles Listen RespondEducate Identify Need Inform AdviseCooperate Find Champions Sponsor Support Share Act on Need Network Communicate Reach out Collaborate

5. 5 We reach our objectives to reduce VPD and achieve high childhood vaccination rates by: 1.Learning and understanding the needs of communities 2.Always responding to an identified need with an action or a program 3.Supporting local health professionals 4.Working closely with and supporting our DPH Immunization Program 5.Educating providers, outreach personnel, volunteers, parents’ groups on the benefits of immunization (continued on next slide)

6. 6 How we reach our objectives (continued) 6. Advocating for all legislation that promotes immunization 7.Providing CMEs on current and future vaccines, the disease they prevent, and the benefits of immunization 8.Developing, promoting and maintaining working relations other organizations, the media and legislators 9.Maintaining a statewide Advisory Committee with Standing and Ad Hoc committees

7. 7 Because of the time limitation I will focus on a few examples only (slides 8-14), which illustrate what is special about our program. To continue viewing the entire slide set go to slide # 15

8. 8 Provide guidance and advice on vaccine purchasing strategies (through the work of our Committee on Vaccine Purchasing Strategies) Advocate to the state’s legislature Support and participate in the development of state’s Immunization Registry Disseminate Information from the State Immunization Program: its publications guidelines announcements Publish names of providers who successfully passed the Office Assessment We work closely with and support our DPH Immunization Program

9. 9 CMEs Every 18 months we organize in each hospital a Grand Rounds seminar on immunization. ~15 programs annually ~500 physicians reached each year Each presentation includes the most current information and is geared to the needs of the medical community  Speakers – our faculty receive an updated set of slides the he/she can choose from Participants receive a packet of up-to-date resources

10. 10 We maintain continuous working relations with the media and the legislators Our pediatricians and experts are available whenever needed to the legislators and to the media for information and advice To maintain our status as a “Universal Distribution State” we advocate for supplemental funding of the state vaccine budget We advocate for all legislation that promotes immunizations Working with the legislature and the media

11. 11 The MCAAP-II runs a State Advisory Committee comprised of pediatricians, family physicians, nurses, public health professionals and representatives from interested parties. This group of 65 members meets quarterly Statewide Advisory Committee Our Champion Immunizer Sean Palfrey, MD, FAAP

12. 12 standing and ad hoc sub committees A standing subcommittee on “Vaccine Purchasing Strategies”, comprised of only clinicians, addresses critical issues of vaccine purchasing and advises the MDPH on vaccine purchasing strategies Ad hoc sub-committees develop and implement projects on: developing and promoting of the Massachusetts immunization registry responding to vaccine safety concerns catching up of adolescents with Hep B immunization educating children, running a school contest and carrying out special programs

13. 13 Building Coalitions within the Advisory Committee MCAAP MAFP NAP NAP School Nurses Massachusetts PTA Rotary Chapters in Massachusetts Vaccine industry representatives (membership limited to open meetings) MA Department of Public Health Immunization Program Maternity and child health WIC MA Department of Education Superintendents of schools Boards of Health Physicians state organizations We recruit various provider groups to the MCAAP Immunization Initiative Many of these participate in continuous or ad hoc activities and projects Our membership includes representatives from the following organizations:

14. 14 Lesson Learned Use comprehensive omnibus approach --- Do All Keep open channels of continuous communication with every one, including those who question vaccines Providers involvement is essential Nurture close working relations with the State’s Immunization Program Universal distribution of vaccines removes major obstacles to immunization. It promotes equity and increases immunization of the underserved and under insured in particular This is made possible by promoting public and private partnerships, maintaining working relations with the legislature, and educating professionals

15. 15 Our news letter Our website www.mcaap.org/ii

16. 16 1. Learning and understanding the needs of communities We work with all: Circles within the AAP, the MDPH, Hospitals, private and public partnerships and with the community at large We network and inform each other on what we need to educate, advocate, support and promote Identify Need Listen Network

17. 17 2. Always responding to a need Examples: Hep B Adolescent Catch-up Program Library Display On-site CME programs Drawing contest & calendar Respond Act on Need Sponsor

18. 18 3a. Supporting local health professionals Work with the Chapter’s Pediatric Council in cooperation with the MCOs and obtaining an agreement on a “Uniform Billing Scheme” with appropriate use of CPT codes when billing for immunizations Survey annually the MCOs about their reimbursement policies for influenza and other vaccines, which are not provided free by the MDPH (continued on next slide) Support

19. 19 3b. Supporting local health professionals (continued) Communicate timely information to the members of MCAAP via Chapter’s Listserve Respond to specific questions from providers Develop and providing informational and educational media and tools for physicians and health professionals Reminder/Recall postcards “Vaccinate Me Today” reminder stickers pamphlets

20. 20 Provide guidance and advice on vaccine purchasing strategies (through the work of our Committee on Vaccine Purchasing Strategies) Advocate to the state’s legislature Support and participate in the development of state’s Immunization Registry Disseminate Information from the State Immunization Program: its publications guidelines announcements Publish names of providers who successfully passed the Office Assessment 4. Working closely with and Supporting our DPH Immunization Program Advise Share Support Communicate

21. 21 Publish the “ShotClock” – a newsletter for clinicians, outreach personnel, advocates, educators and the interested public Maintain a website – www.mcaap.org/ii 5. Educating providers, outreach personnel, volunteers and parents

22. 22 6. Providing CMEs on Pediatric Immunization  Every 18 months we organize in each hospital a Grand Rounds seminar on immunization. ~15 programs annually ~500 physicians reached each year Co-sponsor and organize with our DPH an Annual MIAP Immunization Skills Building Conference ~ 250-300 attendees MIAP - Massachusetts Immunization Action Partnership Educate

23. 23 7. Advocating for vaccine-related initiatives To maintain our status as a “Universal Distribution State” we advocate for supplemental funding of the state vaccine budget We advocate for all legislation that promotes immunizations Advocate

24. 24 Invite various provider groups to the MCAAP Immunization Initiative Maintain continuous working relations with the media and the legislators. Our pediatricians and experts are available whenever needed for information and advice Participate as members in organizations that have common goals Massachusetts Adult Immunization Coalition Massachusetts Health Quality Partners Massachusetts Medical Society 8. Develop working relations with other organizations Collaborate Reach out

25. 25 The MCAAP-II runs a State Advisory Committee comprised of pediatricians, family physicians, nurses, public health professionals and representatives from interested parties. This group of ~65 members meets quarterly 9a. Statewide Advisory Committee Find Champions

26. 26 9b. Advisory Committee with standing and ad hoc sub committees A standing subcommittee on “Vaccine Purchasing Strategies”, comprised of only clinicians, addresses critical issues of vaccine purchasing and advises the MDPH on vaccine purchasing strategies Ad hoc sub-committees develop and implement projects on: developing and promoting of the Massachusetts immunization registry responding to vaccine safety concerns catching up of adolescents with Hep B immunization educating children, running a school contest and carrying out special programs Advise

27. 27 9c. Building Coalitions within our Advisory Committee MCAAP MAFP NAP NAP School Nurses Massachusetts PTA Rotary Chapters in Massachusetts Vaccine industry representatives (membership limited to open meetings) MA Department of Public Health Immunization Program Maternity and child health WIC MA Department of Education Superintendents of schools Boards of Health Physicians state organizations We recruit various provider groups to the MCAAP Immunization Initiative Many of these participate in continuous or ad hoc activities and projects Our membership includes representatives from the following organizations: Share Cooperate

28. 28 Lesson Learned Use comprehensive omnibus approach --- Do All Keep open channels of continuous communication with every one, including those who question vaccines Providers involvement is essential Nurture close working relations with the State’s Immunization Program Universal distribution of vaccines removes major obstacles to immunization. It promotes equity and increases immunization of the underserved and under insured in particular This is made possible by promoting public and private partnerships, maintaining working relations with the legislature, and educating professionals

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