Physicians in New York City

Tuberculosis testing in New York City

As of January 12, 2017, the New York City health code now requires additional reporting for children less than five years of age with a positive test for TB infection (e.g., interferon gamma release assay [IGRA] or tuberculin skin test [TST]), including documentation of subsequent evaluation to rule out TB disease.  An up-to-date version of the Health Code (§11.21) can be found at

2018 Advisory # 2:  Influenza Advisory

  • New York State has declared an influenza public health emergency
  • In addition to vaccinating adults, pharmacists may now also temporarily administer flu vaccines to children between 2 and 17 years of age with an appropriate non-patient specific standing order
  • Flu vaccination is recommended for all persons 6 months of age and older
  • All healthcare personnel should receive a flu vaccination
  • Antiviral treatment is recommended as early as possible for patients with confirmed or suspected influenza who are hospitalized, seriously ill, or ill and at high risk of serious influenza-related complications

January 30, 2018

Dear Colleagues,

On January 25, 2018, Governor Andrew Cuomo declared an influenza public health emergency for New York State (NYS). In addition to administering flu vaccines to adults, licensed pharmacists are now temporarily allowed to administer flu vaccines to children between 2 and 17 years of age with an appropriate non-patient specific standing order.

The New York City (NYC) Department of Health and Mental Hygiene (DOHMH) reminds clinicians that it is not too late in the season to administer flu vaccine and that, when indicated, antiviral medications should be used for influenza treatment and prophylaxis.

Influenza activity in NYC remains elevated and robust, as expected during a season when influenza A (H3N2) viruses predominantly circulate (Figure). During the past surveillance week, 5.3% of outpatient visits were for influenza-like illness (ILI), and 30% of specimens submitted for respiratory virus testing were positive for influenza. During past seasons when H3N2 viruses have predominated, higher overall and age-specific hospitalization rates and increased mortality have been observed, especially among older people, very young children, and persons with certain chronic medical conditions, compared with seasons during which influenza A (H1N1) or influenza B viruses have predominated. Weekly updates on current NYC influenza activity may be found at

Flu Vaccine Recommendations and Supply:
Flu vaccine coverage levels in NYC are below the Healthy People 2020 Goals for all age groups. A recommendation from a clinician is the most important factor in determining whether someone is vaccinated. Annual flu vaccination is recommended for all persons 6 months and older. Anyone who has not yet been vaccinated this season should get a flu vaccine now.

If you need more vaccine, flu vaccine is still available for purchase although some specific products may not be available. For a list of available products and where to purchase them, visit DOHMH still has Vaccines for Children (VFC) vaccine available for enrolled providers. Providers enrolled in the VFC program who need to order additional vaccine or have questions about their flu vaccine order, can visit to log onto the Online Registry to place or track a re quest. You may also send an e-mail to If you do not have flu vaccine or cannot buy additional doses, refer your patients to a pharmacy for vaccination. Most chain pharmacies have vaccine and will be able to vaccinate children, although they likely do not have vaccine for children under 3 or 4 years of age. DOHMH has limited information about small retail pharmacies. We suggest checking with those pharmacies near your practice.

Detailed information on influenza prevention and control, including flu and pneumococcal vaccine recommendations, is available in DOHMH’s City Health Information: Influenza Prevention and Control, 2017-2018 publication For further information on ordering vaccine, vaccine supply, standing orders, sample refusal forms, high-risk groups, patient education materials, and additional resources to promote influenza vaccination, please visit

Influenza Vaccination for Healthcare Personnel:
Annual flu vaccination of all healthcare personnel is considered the standard of care. NYS Public Health Law requires all healthcare facilities and agencies licensed under Articles 28, 36 or 40 to document their healthcare personnel influenza vaccination status and to require healthcare  personnel who do not receive flu vaccine to wear a mask through the period that the NYS Health Commissioner deems influenza to be prevalent. On December 13, 2017, the NYS Health Commissioner declared influenza to be prevalent statewide (

Influenza Antiviral Medications:
One of three influenza antiviral medications – oseltamivir (Tamiflu), zanamivir (Relenza), or peramivir (Rapivab) – should be used for treating influenza infections, esp ecially in persons at high risk for serious complications of influenza infection. Peramivir is only available as an IV formulation and is approved for use in persons two years of age and older. Only oseltamivir and zanamivir are approved for prophylaxis. Zanamivir should not be used in persons with underlying airways disease, such as asthma or COPD. Antiviral treatment should be started as early as possible for any patients with confirmed or suspected influenza who are hospitalized, seriously ill, or ill with a high risk of serious influenza-related complications. The latter group includes:

  • Persons over 65 or under 2 years of age
  • Pregnant women, or those who have given birth within the previous 2 weeks
  • Persons with diabetes, chronic lung (e.g., asthma), heart, kidney, liver, or blood disorders, neurological disorders compromising respiration, history of stroke, morbid obesity (i.e., body-mass index > 40), or who are immunocompromised (e.g. HIV, AIDS and/or cancer)
  • Persons under 19 years of age who are on long-term aspirin therapy

Treatment should begin as soon as influenza is suspected, regardless of vaccination status or rapid test results, and should not be delayed for confirmatory testing. Further recommendations on the use of antiviral drugs are available at:

Reporting of Flu Vaccine Doses Administered:
Providers must report all doses of vaccine administered to children less than 19 years of age to the Citywide Immunization Registry (CIR). Providers administering vaccines to adults 19 years and older can also report these doses to the CIR, provided they obtain verbal or written consent to do so. For more information, please visit Additionally, effective October 2014, pharmacists and registered nurses in NYS must report all vaccines administered to adults 19 years and older to the CIR, with the patient’s verbal or written consent. Information on the reporting requirement is available at:


Demetre Daskalakis, MD, MPH
Deputy Commissioner, Division of Disease Control

The NYC Department of Health and Mental Hygiene is conducting a large-scale recruitment for school physicians to work at NYC’s public schools.  The candidates being sought should be licensed physicians (specifically pediatricians, family medicine doctors, adolescent medicine doctors, or preventive medicine doctors) who also have a strong public health/population health background (ideally an MPH in addition to MD), and who would like a rewarding opportunity with flexible hours.  Details on available positions:

Health Barriers to Learning: The Prevalence and Educational Consequences in Disadvantaged Children describes the HBLs and the supporting evidence base for their impact on academic success.  It also describes the disproportionate prevalence of HBLs in disadvantaged children, the extent of unmet need for services for identification, management and treatment, and each HBL’s impact on learning.  The report offers recommendations for better identification, management, and treatment of these barriers.

New York City Influenza Update

Influenza Prevention and Control 2016-1


New York City Pediatrician comments on Vitamin Supplements

Hear and see Dr. Lisa Thebner with Kaity Tong on PIX Channel 11 News comments on vitamin and sport drinks overuse.

New York City Advocating for HPV Vaccine

On Monday, August 11, 2014 the New York City Health Department issued a Press Release announcing the launch of a citywide HPV vaccination campaign.  Read more about the Campaign here.  Additional resources:

Dear Colleagues:

There are important changes to the Vaccines for Children (VFC) program vaccine ordering process.  The Centers for Disease Control and Prevention recently launched a new vaccine ordering system which the New York City Department of Health and Mental Hygiene Bureau of Immunization must use to place VFC orders.  This new system requires providers to report on-hand VFC vaccine inventory including lot numbers when ordering VFC vaccines.

The Online Registry VFC Vaccine Ordering and Management Tool has been modified to allow entry of vaccine lot numbers.  When ordering VFC vaccines, providers should log on to the Online Registry at as is currently done, select the VFC icon on the main tool bar, and go to the “Order VFC Vaccine” section.  Next, providers will follow the current six-step ordering process, but in step 3 will need to select the vaccine lot number and expiration date from the drop-down list for each vaccine type in their VFC inventory.  The provider will then enter the number of doses on-hand.  The lot numbers for shipped VFC vaccine will have been pre-populated.  If providers borrowed VFC vaccines, they will need to include the lot numbers, expiration dates, and number of doses of privately-purchased vaccines on-hand that are being used to replenish VFC doses.

For providers using the Online Registry to report immunizations to the Citywide Immunization Registry, please note that VFC vaccine lot numbers are now populated in “My Lot” lists for easy selection when using the “Current Immunization”, “Modify History” and “Add History” functions.

A set of slides which shows the VFC vaccine ordering process is available at this link.  For questions or assistance, please email us at or call the Bureau of Immunization Hotline at 347-396-2400.  We thank you for vaccinating New York City children to protect them from vaccine-preventable diseases.

Jane R. Zucker, MD, MSc

The New York City Health Code now requires written parental consent before direct oral suction can be performed as part of circumcision.  For further information, see here.  Parental consent forms in English and Yiddish are also available.

TB Testing No Longer Required to School Entry
Effective June 12, 2012, the New York City Department of Health and Mental Hygiene no longer requires that new entrants to secondary schools in New York City undergo testing for latent tuberculosis infection.

The Child & Adolescent Examination Form (CH205) can be accessed and completed through the Citywide Immunization Registry (CIR).  By accessing the form in this way, immunization and lead data will automatically pre-populate the form.  The completed forms can be printed or faxed automatically to the school, camp or daycare.  Please see attached for a set of instructions.

Dr. Thomas Farley, Commissioner of the New York City Department of Health and Mental Hygiene, has distributed a letter detailing the Medical Requirements for Students for the 2012-2013 school year.  In addition, he has provided a Tuberculosis Risk Assessment Questionnaire to determine which students may require testing for tuberculosis.

Dear Colleagues and Friends,

The New York City Health Department is eager to share with you some exciting new resources and tools related to adolescent sexual and reproductive health.  As part of Mayor Bloomberg’s Young Men’s Initiative,  we have developed Best Practices in Sexual and Reproductive Health Care for Adolescents (Best Practices) and the Teens in NYC Web-based Portal (TNYC Portal).

The Best Practices reflect current evidence, guidelines and input from many experts in the field, and are endorsed by: the New York State Department of Health; the New York City Health and Hospitals Corporation; the American Academy of Pediatrics, District II, NYS; the Academy of Family Physicians, NY County, NYS; and the Society for Adolescent Health and Medicine, NYS.  They are available online (with links to a variety of resources), and can be found by visiting and searching for Adolescent Sexual Health.

The TNYC Portal, open to NYC providers of adolescent sexual and reproductive health services from any specialty (pediatrics, primary care, family medicine, adolescent health, family planning, and obstetrics and gynecology), allows providers to:

  • Assess their performance relative to the Best Practices
  • Inform quality improvement work
  • Receive updates on resources and training for NYC providers
  • Become eligible for inclusion in the TNYC Preferred Referral Guide, a popular guide that will soon be available as a mobile app and listsproviders that offer high-quality sexual and reproductive health services to adolescents.

To join the TNYC Portal or get more information, email us at

Deborah Kaplan, MPH, R-PA
Assistant Commissioner
Bureau of Maternal, Infant and Reproductive Health
NYC Department of Health and Mental Hygiene
42-09 28th Street
Long Island City, NY 11101
tel.   (347) 396-4483
Alzen Whitten, MPA
Director, Adolescent Reproductive Health Program
Bureau of Maternal, Infant & Reproductive Health
NYC Department of Health & Mental Hygiene
42-09 28th Street, 10th Floor, 10-131
Long Island City, NY 11101
Office: 347-396-4475