1. Efforts to Increase Sustainable Influenza Vaccination Coverage in Pierce County, Washington Emily Less Public Health Associate Office for State, Tribal, Local and Territorial Support Centers for Disease Control and Prevention 2016 PHAP Spring Seminar April 4 th, 2016 Centers for Disease Control and Prevention Office for State, Tribal, Local and Territorial Support

2. Pierce County, Washington  ~ 831,000 residents in rural and urban settings  17 school districts serving 144,644 children  1 primary care physician per 1,440 people http://www.countyhealthrankings.org/

3. 2014-2015 2012-2013 2013-2014 2015-2016

4. * FluView: Influenza Hospitalizations Surveillance Network, CDC, http://gis.cdc.gov/GRASP/Fluview/FluHospRates.html, 03/21/16 2014-2015 2013-2014 2015-2016 65+ yrs 5-17 yrs

5. Immunization Coverage * Data from http://www.cdc.gov/flu/fluvaxview/coverage-1415estimates.htmhttp://www.cdc.gov/flu/fluvaxview/coverage-1415estimates.htm  Immunizing children is an effective strategy to prevent deaths in adults  In U.S., adults are vaccinated at higher rates than school-aged children

6. School-Located Influenza Vaccination Clinics (SLIV)  Best practice accepted by parents and providers  Beneficial for emergency preparedness  Pandemic  Mass dispensing  Feasible due to Vaccine for Children (VFC) program and FluMist® * Tacoma-Pierce County Health Department, tpchd.org/flufighter

7. *Tacoma-Pierce County Health Department

8. In 2015-2016 flu season, vaccinated 3,290 students at 47 schools *Tacoma-Pierce County Health Department In 2015-2016 flu season, vaccinated 3,290 students at 47 schools

9. Searching for Sustainability  Literature search  SLIV accepted by parents, providers and schools  Key Informant Interviews of SLIV programs  School Districts  Local Health Jurisdictions  Private Provider Offices  For-profit Medical Companies  State Health Departments  Non-profit Immunization Coalitions * Citations, references, and credits – Calibri, 11pt

10. Searching for Sustainability (continued)  Diverse Models for In-School Flu  Sources for staffing and coordination  Innovative Ideas  Coordination support from large health systems  Incorporating back to school vaccines (e.g. Tdap and HPV)  Funding from private insurance companies  Consistent immunization champion * Citations, references, and credits – Calibri, 11pt

11. Private Provider Pilot Project  Formed Community Advisory Group  Examined financial feasibility of private provider led clinics  Recruited private office to host in-school flu  Recruited private office to host back to school vaccine clinic open to community  Encouraged billing for administrative fee for children with insurance coverage  Enlisted rural pharmacy as VFC provider * Citations, references, and credits – Calibri, 11pt

12. Providers Can Recoup All Costs from SLIV *Tacoma-Pierce County Health Department

13. Next Steps  Establish partnerships between schools and private provider offices  Recruit a minimum of 10 more providers for 2016-2017 Flu season  Increase flu vaccine availability in high poverty areas

14. Summary  SLIV is a best practice for increasing vaccination coverage of school aged children  Private provider led vaccination is an innovative and financially feasible model  By 2017, 10 more providers will provide SLIV services in Pierce County, WA

15. For more information, please contact CDC’s Office for State, Tribal, Local and Territorial Support 4770 Buford Highway NE, Mailstop E-70, Atlanta, GA 30341 Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348 E-mail: OSTLTSfeedback@cdc.govWeb: http://www.cdc.gov/stltpublichealthOSTLTSfeedback@cdc.govhttp://www.cdc.gov/stltpublichealth The findings and conclusions in this presentation are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Emily Less eless@cdc.gov (253) 625-1362 Centers for Disease Control and Prevention Office for State, Tribal, Local and Territorial Support