Galveston County Health District Immunization Programs

History 1968- 1970 Immunizations given 2 half-days a week on the mainland by a TDH nurse; also given though Well Child and OB clinics; immunization compliance assessed during well child conferences, well baby home visits, and by school nurses 1970’s Galveston Health Department became part of GCHD; immunizations still only 2 half-days per week; CHN’s helped with back-to-school rush; clerk sent out immunization reminders

History (cont) 1980’s Immunization Nurse funded; CHN’s worked closely with day care centers and schools; no formal tracking program; Immunizations were provided on the island, mainland, and in outreach locations in the North county 1990’s Clerk hired; TVFC program started in 1994; ICES and CASA systems initiated; first CASA report showed Galveston at 43% (children 2 and under) TVFC = Texas Vaccines for Children Program ICES = CASA =

History (cont) 2000 to present ICES updated to TWICES (web-based electronic immunization records); GCHD was one of the first to pilot PICS (TDH pharmacy inventory) Currently 3 satellite clinics open a total of 80 hours per week 8 FTE’s (Immunization nurses and clerks) 42 VFC providers (GCHD responsible for training, monitoring, follow-up site visits) ~ $ 375,000 budget (with ~ $85,000 reimbursed) TWICES = web-based electronic immunization records ImmTrac= PICS =

Eradicate vaccine preventable diseases from Galveston county TDH Vision and Mission Vision Eradicate vaccine preventable diseases from Galveston county Mission To immunize all children in Galveston county by age two in accordance with the current Texas Department of Health recommendations.

PREVENTION BY MMUNIZATION PRIORITY #8: PREVENTION BY MMUNIZATION Immunize Children and Adults to Prevent Infectious Diseases.

Strategic Health Plan Goals Goal 1: Designate leadership and establish local plans and goals Goal 2: Improve availability and accuracy of local data to enhance tracking, assessment, and feedback Goal 3: Identify and reduce barriers to immunizations Goal 4: Increase education and awareness among all responsible groups Goal 5: Define, align, coordinate, and seek resources Entire Strategic Health Plan can be viewed at www.gchd.org

Goal 1: Designate leadership and establish local plans and goals Objective One: Establish the Galveston County Health District as the lead organization for local planning to improve immunization rates using the medical home model in Galveston County. Galveston County Immunization Advisory Council was established and had first meeting on 7/8/04 Some examples of how goals are met

Increase number of Vaccines for Children (VFC) providers Goal 2: Improve availability and accuracy of local data to enhance tracking, assessment, and feedback Increase number of Vaccines for Children (VFC) providers 2003: 35 VFC providers Currently: 42 providers Retrospective kindergarten studies 2003 study (2/04) assessed immunization status of children who would have been 2 years old in 1999- 2000; 60.7% adequately immunized (4-3-1-3-3) by age 2 and 87.4% by age 5. National goal is 80%.

Goal 2: Improve availability and accuracy of local data to enhance tracking, assessment, and feedback (cont) Day care studies 2003 study (completed January 2004) 155 childcare facilities 5304 records Initial visit 82.4% “up-to-date” (in compliance with TDH Minimum State Vaccine Requirements for Texas Children) 30- day follow-up visit: 99.3% up-to-date Reports available at www.gchd.org

Goal 4: Increase education and awareness among all responsible groups Education efforts January- June 2004: Presented or hosted 5 educational activities with a total of 80 participants Participated in at least 2 health fairs and the Teen Health Round-up Answered 1,387 phone calls related to vaccination from school nurses, medical offices, and the public Participated in educational activities related to bioterrorism/ emergency management (mass vaccination clinics, Strategic National Stockpile, mass antibiotic administration)

Annual Activities National Infant Immunization Week Activities Kid’s Fest- Back-to-School Immunization Clinics Senior Health Fests with “Flu Shot” activities

National Infant Immunization Week April 26- May 1, 2004 Regular immunization clinics + 1 outreach clinic per day- locations determined by “pockets of need” (19 immunization sessions) 281 people immunized 786 immunizations given 39 volunteers 4,000 fliers distributed

Kid’s Fests- Back-to-School Immunizations

Kid’s Fests- Back-to-School Immunizations Texas City and Dickinson Immunization Clinics relocated to La Marque office July 26- August 17 Galveston Clinics remain the same 2003: 3,212 immunizations given at La Marque Clinic; 4,692 immunizations total in August 2004

Senior Health Fests October 2003 activities: 6 locations 461 immunizations given Other activities included B/P checks, diabetes screenings, exercise demonstration, assistance with QMB

“Thinking Progressively for Health” Award Presented to GCHD staff at Texas Public Health Association meeting April 18- 20, 2004 For aggressive strategies being taken in Galveston County to improve immunization rates with innovative outreach techniques implemented by the District such as the "medical home model" of immunization delivery which promotes the delivery of immunizations within ones medical home and encourages clinical preventative healthcare

2004 TDH Immunization Audit July 2004   4-3-1 * 4-3-1-3-3 ** Drop-out rate: DtaP Drop-out rate: Hep B Missed opportunities LaMarque 80% 13% 7% 0% Galveston 81% 16% 3% Dickinson 70% 68% 23% 9% 2% Texas City 75% 20% 5%

Immunization Staff