Immunizations for Physicians

In an effort to consolidate and organize the rapidly changing information on vaccinations for children, this page has been re-organized to make it easier to navigate.  AAP District II is consolidating vaccine information so that it is not duplicated on the Chapter web sites.

Table of Contents


Get Smart Campaign

This link will take you to the New York “Get Smart” toolkit, developed as an electronic resource for healthcare providers, facility administrators, school nurses and other professionals.  You’ll find links to educational materials and please check pages 4-14 for CDC clinical guidelines that may be printed out and distributed at your facility for staff meetings, quick reference, etc.

Additionally, please check out the NYS Department of Health Antibiotic Resistance page with other available materials.

Please enlist other physicians, nurse practitioners, physician assistants in your area, who might prescribe antibiotics in their practices, to spread the word about the Get Smart Campaign.  We are happy to supply materials when possible –  please feel free to use this PowerPoint slide deck.

Also included in this week’s announcement: a WHO overview of “woeful misconceptions” about AR.

Thanks for all you do to further the message of the Get Smart Campaign!

Visit CD’s Get Smart Website for activities, events, resources, promotional materials, fact sheets and educational resources.


 

 Vaccine and Immunization Information for Providers

(current schedules, Vaccine Information Statements, supply, storage, administration tools, patient education)

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NYSIIS

      NYSIIS was developed as required under Article 21, Title 6, Section 2168 of the Public Health Law.  This law, which took effect January 1, 2008, mandates health care providers to report all immunizations administered to persons less than 19 years of age to the New York State Department of Health (NYSDOH).  The law also requires that immunization histories of all persons less than 19 years of age who receive vaccines after January 1, 2008 also be recorded in NYSIIS, if those histories have not already been reported.

     The Public Health Law provided a two year implementation period to enable providers to be phased in through continuous regional roll out.   Between 2008 and 2011 multiple training opportunities and methods were available to all providers statewide.   It is important to note that those who are not currently participating are out of compliance with the legislative mandate.   Failure to comply with public health law may result in monetary penalties.  It is imperative that any provider organization that has not yet attended training or begun reporting to NYSIIS take the necessary steps to do so by reviewing the contents of this letter.   Starting in 2012, classroom trainings are no longer be offered.  However, webinar trainings and onsite opportunities are available.

      There is a lot of information on the Health Commerce System (HCS) NYSIIS page, especially under “Training Information” and “Information for Providers.”  Please visit frequently!

       Access to the NYSIIS will be through the HCS, so it is important to sign up to the network in advance.  

The NYSIIS team is pleased to announce that development of the NYSIIS Online Self-Guided Training Tutorials is now complete!  The NYSIIS tutorials were designed as a complement to both the classroom and webinar training methods.  These tutorials offer training participants more training flexibility and an opportunity to review specific functions and concepts as needed.  There are 10 self-paced tutorials that demonstrate the core functions for utilizing NYSIIS.

The Self-Guided Training Tutorials link can be accessed from the NYSIIS Training page on the Health Commerce System: https://commerce.health.state.ny.us/hpn/bcdc/immunization/training_info.html

Below is a list of the topics available for viewing:

  • Tutorial 1: Accessing NYSIIS & Verifying Organizational Information
  • Tutorial 2: Adding New Users
  • Tutorial 3: Searching for a Patient
  • Tutorial 4: Entering a New Patient
  • Tutorial 5: Viewing the Immunization History and Recommendation Screen
  • Tutorial 6: Adding Immunizations
  • Tutorial 7: Generating Patient Specific Reports
  • Tutorial 8: Setting Up the NYSIIS Inventory Module
  • Tutorial 9: Entering Schools, Providers, and Clinicians
  • Tutorial 10: Generating Reminder/Recall Letters
  • Tutorial 11: Ad Hoc Report
  • Tutorial 12: Assessment Report
  • Tutorial 13: Benchmark Report

NYSIIS Training Update:

Note:  This is not formal user training but rather an opportunity to update current users on implementation and enhancement activities, share some tips and tricks for using specific features, and provide a forum for new and veteran users to discuss successes and challenges.  Invitation with registration instructions and agenda will be sent in early September.

Dates, Times and Locations:

Tuesday, October 4, 2016    1:00 p.m. – 4:00 p.m.
Central Region – Syracuse

Comfort Inn & Suites
6701 Buckley Road
Syracuse, NY 13212

Monday, October 17, 2016    1:00 p.m. – 4:00 p.m.
Long Island Region – Plainview

Hilton Garden Inn
1575 Round Swamp Road
Plainview, NY 11803

Wednesday, October 5, 2016    9:00 a.m. – Noon
Finger Lakes Region – Rochester

RIT Inn & Conference Center
5257 West Henrietta Road
Henrietta, NY 14467

Tuesday, October, 18, 2016    9:00 a.m. – Noon
Lower Hudson Region– Tarrytown

DoubleTree
455 South Broadway
Tarrytown, NY 10591

Thursday, October 6, 2016    9:00 a.m. – Noon
Western Region– Buffalo

Hilton Garden Inn
4201 Genesee Street
Cheektowaga, NY 14225

Thursday, October, 20, 2016    9:00 a.m. – Noon
Capital District Region – Clifton Park

Hilton Garden Inn
30 Clifton Country Road
Clifton Park, NY 12065

AGENDA of Meetings:

9:00 a.m. Meeting
Rochester, Buffalo, Clifton Park, Plainview
1:00 p.m. Meeting
Syracuse, Tarrytown
Topics
9:00 a.m. – 9:30 a.m. 1:00 p.m. – 1:30 p.m. Welcome and Program Updates
9:30 a.m. – 10:00 a.m. 1:30 p.m. – 2:00 p.m. Lead Poisoning Prevention Program Latest and Greatest
10:00 a.m. – 10:30 a.m. 2:00 p.m. – 2:30 p.m. P.A.I.S – What does that mean to my practice?
10:30 a.m. – 10:50 a.m. 2:30 p.m. – 2:50 p.m. Networking (aka Break)
10:50 a.m. – 11:30 a.m. 2:50 p.m. – 3:30 p.m. To return or to waste? That is the question…
11:30 a.m. – Noon 3:30 p.m. – 4:00 p.m. NYSIIS Ask the Experts (Seriously, ask us anything)

 

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New York State Immunization Information System (NYSIIS) Temperature Log Training webinar

Held on August 6, 2014

 The webinar was re-recorded into two separate trainings:

Entering VFC Temperature Logs in NYSIIS

NYSIIS Temperature Log Reports

Handouts from the Webinar:

The link below will take you to the NYSDOH Immunization Update Webinar Series web page where you will find the programs and how to access them. If clicking on the link below doesn’t work, please copy and paste the link into your web browser.
http://www.health.ny.gov/prevention/immunization/providers/webinar_series.htm

Effective January 1st, 2015, the New York State Department of Health (NYSDOH) Vaccine Program will require Vaccine for Children (VFC) Program providers to use the NYSIIS Temperature Log (Temp Log) to record twice daily temperatures for their vaccine storage unit refrigerator and freezer containing VFC vaccines.  Reporting storage unit temperatures that hold “private” vaccine is not required.  Temperature monitoring of publicly purchased vaccine for other programs, e.g., STD clinic or Hepatitis B Program, may continue to be recorded on paper Temp Logs if those vaccines are kept in a storage unit that does not contain VFC vaccine. DO NOT fax paper Temp Logs to NYSDOH VFC Program unless requested to do so.

Providers are not required to use NYSIIS Temperature Log Reports.

If you have any questions about the NYSIIS Temp Log or Reports, please contact Nancy Minch or Jessica Nadeau, NYSDOH Bureau of Immunization at 518-473-4437.


NYS Vaccines for Children Program

 www.health.ny.gov/prevention/immunization/vaccines_for_children.htm

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Vaccine Safety Basics

 


 Seasonal Influenza Information for Health Care Providers

For detailed influenza information, see the AAP Red Book Online Influenza Resource page or the CDC FluView. All What’s the Latest with the Flu messages are archived.

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Provider Training and Education

 

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Parent Resources

(Information Duplicated on our Parents page)

General Immunization and Vaccine information

Vaccine Safety

Seasonal Influenza


Vaccine Exemptions

There are NY State Policies for Vaccine Exemptions for School-aged Children.  Physicians should provide schools with a standardized form.

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Measles and Rubella Initiative

In collaboration with the Measles and Rubella Initiative (M&RI), the American Academy of Pediatrics is offering free resources to help promote measles vaccinations in the clinical setting.  The materials include posters, postcards, stickers, and temporary tattoos designed by children’s illustrator, Sophie Blackall.  The messages for measles vaccination are just as important here in the US as they are abroad especially given the current outbreaks throughout the nation.  Now is a perfect time to re-engage with your patients and parents to promote vaccinations.  I encourage you to share the text below with your member listservs and on your websites.  Members simply complete a quick survey (~1 minute), and the materials are delivered directly to their office at no charge.

Ivy and Bean posters are available to remind parents to vaccinate against measles
The AAP is partnering with the Measles & Rubella Initiative in a campaign that includes posters and related materials for use in practices designed by famed author and illustrator Sophie Blackall. The materials feature the beloved Ivy and Bean characters as they illustrate lessons on the importance of getting vaccinated. The campaign is a positive, relatable way to convey support for childhood immunization generally, and for measles vaccination specifically.  Materials are free of charge; for more information and to order resources, please visit http://www2.aap.org/international/immunization/IvyAndBean/.

If you have any questions or comments, please feel free to contact me at 847/434-7113 or by e-mail at kpatel@aap.org.

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Other Provider Resources

 

  • CDC, Epidemiology and Prevention of Vaccine-Preventable Diseases “The Pink Book”
    The Pink Book provides physicians, nurses, nurse practitioners, physician assistants, pharmacists, and others with the most comprehensive information on vaccine-preventable diseases.  www.cdc.gov/vaccines/pubs/pinkbook/default.htm
  • Immunization Action Coalition (IAC)
    The IAC is a premier immunization resource featuring comprehensive information on vaccines and vaccine preventable diseases.  These resources are intended for health care professionals and parents.  www.immunize.org/

Additional Topics

Guidance on Obtaining Available Influenza Vaccine for Children – This advisory is to notify medical providers in New York State about the availability of influenza vaccine from Sanofi Pasteur and the ability and proper procedure to use influenza vaccine supplied by the Vaccines for Children (VFC) Program for children who are privately insured.  For questions about VFC influenza vaccine orders, please contact the Bureau of Immunization, at 347-396-2489, or email nycimmunize@health.nyc.gov

 

Administration Fee Increase for VFC-Eligible Children

The maximum amount that New York State Vaccines for Children Program (NYS VFC) providers may charge for vaccine administration to VFC-eligible children has been increased to $25.10 excluding Medicaid and Child Health Plus enrollees.  Medicaid Fee-For-Service continues to reimburse $17.85 for each VFC vaccine administration.  NYS VFC Providers may charge up to $25.10 for each vaccine administered to children who are eligible for the VFC program if they are uninsured, underinsured, American Indians or Alaskan Natives.  NYS VFC providers must waive the administration fee if the client is unable to pay the cost.

Vaccine administration to children enrolled in Medicaid Managed Care or Child Health Plus is reimbursed according to contract.  Contract reimbursement rates are agreed upon by providers and insurance plans.  Information on VFC program eligibility can be found on the Department of Health website:  http://www.health.ny.gov/prevention/immunization/vaccines_for_children.htm

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Post-exposure Prophylaxis (PEP) for HIV

Dr. Agins of the NYSDOH AIDS Institute highlights the updated 2014 clinical guidelines for prescribing post-exposure prophylaxis (PEP) in a recently published letter, and lists additional resources that support the provision of PEP.  The aim of this letter is to encourage clinical providers across NYS to be vigilant in identifying cases where PEP may be prescribed to prevent HIV infection; a critical step in ending the epidemic in New York.

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Are Pharmacies Stealing Your Patients?

The scariest word for a primary care physician these days isn’t ACA, reimbursements, or even liability insurance.  It’s attrition.  The great migration of patients continues to shift from the primary care practice to other facilities.  They will go where there’s quick and easy access to good care. In recent years, that has meant a migration to urgent care centers.  Now, the latest trend, and potentially far more damaging to a physician’s practice, comes from pharmacies.

Physicians are long accustomed to sending their patients to pharmacies to fill a prescription.  But, now they’re doing so and patients aren’t coming back.  That’s because pharmacies are adding clinicians, accessible both on-site and remotely.

Recently, Walgreen’s announced a partnership with MDLIVE in which it will provide their customers with online, on-demand access to physicians.  A pilot of the program has launched in a few states and additional ones will be added soon.  The role the pharmacy is undergoing a dramatic transformation and its impact on the healthcare system should not be discounted.

In the world of vaccines, patients are increasingly receiving their immunizations at urgent care clinics and now pharmacies.  And as these care centers build out the services they provide, patients will have limited incentive to return to their primary care physicians.  When a patient leaves a practice, for a vaccination or otherwise, if they’re satisfied with their care, they’re not coming back.

Primary care practices can’t afford to let this migration continue.  Rather than lament the shifting dynamics, physicians are beginning to implement meaningful and successful tactics to keep their patients:

  • Communicate early and often – provide frequent, proactive communication to inform patients of their care history and recommendations for future vaccinations
  • Build on their trust in you – remember, patients may appreciate the convenience of an urgent clinic or pharmacy, but you can leverage your practice’s earned trust, respect and credibility
  • Raise awareness of vaccines – many patients don’t understand the significance of vaccines or the consequences of failing to adhere to guidelines; provide patients with educational and informational material, either from the Centers for Disease Control or other sources
  • Make it easy – vaccines are confusing and the requirements, guidelines and recommendations frequently evolve; help your patients by providing crystal-clear guidance on what they need to do, when and how

So, what will you do as a primary care physician to compete with the convenience of jelly beans, allergy medications and immunizations all in the same store?

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Increasing Awareness and Utilization of Cancer Preventing Vaccine

Human papillomavirus (HPV) is the most common sexually transmitted virus in the United States, so common that nearly every sexually active person will acquire it at some point in his or her life. When not cleared by one’s immune system, certain strains of the virus are linked to serious health issues including genital warts and numerous types of cancer.

The dangers of HPV are well known, and preventative treatments have been available for nearly a decade, and yet, coverage remains low. In 2006, the first vaccine was licensed to prevent HPV-related diseases. The vaccine, Gardasil, is given in a three-part series over the course of six months. Initially, only approved for use by girls, the Center for Disease Control and Prevention (CDC) now recommends that both females and males between the ages of 9 and 26 receive the vaccine as the incidence of HPV-associated cancers affecting men continues to grow.

Since the introduction of the HPV vaccine, numerous studies have highlighted its positive health contributions. In a 2013 study, the CDC found that the proportion of girls infected by the four strains of HPV covered by the vaccine decreased 88% among those who had been vaccinated. More recently, a study of 26,000 teen girls found that those who received all three doses of the vaccine were 44% less likely to be infected with cervical dysplasia and 43% less likely to be infected with genital warts. In addition to preventing infection, another recent study concluded that the vaccine could save significant amount of money by avoiding future cancer care.

While the HPV vaccine has proven effective, adoption among men and women remains low. According to the CDC, only 40% of women and a paltry 6% of males between ages 19 to 26 reported at least one dose of the HPV vaccine in 2013. In addition, a significant percentage of individuals fail to complete the recommended three doses. A study completed by the CDC found only 38% of girls between the ages of 13 and 17 completed the series; for boys in the same age group, only 14% completed all three doses.

In March of 2015, Gardasil 9 was officially launched offering an enhanced version of the vaccine to protect against nine strains of HPV. With this increased protection, there is a belief that a greater percentage of adolescents will get immunized.

However, with 33,200 cases of cancer each year tied to HPV, it is important that coverage and completion of all three doses of the vaccination improve. Healthcare professionals should make a concerted effort to communicate the benefits of the vaccination to both teens and their parents. By discussing the potential risks of going unvaccinated, we can increase coverage and ensure more individuals do not suffer from this all too common and preventable disease.

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