1. Henderson County Immunization Coalition A partnership of Pediatric and Family Medicine in Hendersonville, NC

2. Coalition Structure Henderson County Department of Public Health Blue Ridge Community Health Services Rainbow Pediatrics Hendersonville Family Medical Center Hendersonville Pediatrics Park Ridge Pediatrics Henderson County Immunization Coalition Group Organizers: Kristina Henderson, R.N. and Justina Hall, R.N., B.S.N.

3. Mission: Improving immunization rates by eliminating barriers, sharing resources, and collaborating to stop the spread of vaccine preventable disease. ▪ Why did we start a coalition? ▪ How was the idea developed? ▪ What makes this effort unique? ▪ Have we made a difference? ▪ What does the future hold for Henderson County Immunization Coalition (HCIC)

4. Title and Content Layout with Chart School Year

5. 2014 Pertussis Cases in North Carolina

6. How the idea developed Step 3 Engage Step 2: Gauge Interest Step 1: Target Audience Peds & Family Medicine Providers Practice Managers Nurses Medical Assistants Establish contact at each office Obtain email addresses Send out survey of interest News-letter Regular Meetings Outreach efforts to strategic groups

7. Target Audience: Health Care Professional s Immunization recommendations change regularly. Acquiring resources for staff’s continuing education opportunities, and quality patient education materials can be overwhelming. No clear line of communication established with pediatric/family medicine practices and public health. Having complicated and at times difficult discussions with vaccine hesitant/resistant parents is time consuming. It is necessary to be familiar with studied effective ways to have decisive discussions with parents.

8. Gauge Interest: Method 1.Developed list of all pediatric provider practices in the area 2.Called each one, spoke with the practice manager and introduced ourselves and the idea for establishing a community of pediatric providers that advocates immunizations. 3.Once the initial idea was introduced we sent out the slide we planned to use in the local movie theatre to promote new school requirements which included all participating practice names.

9. Movie Theatre Slides to raise awareness on new school requirements December 2014: Short CDC PSA then this slide: April 2015: Short CDC PSA and this slide:

10. Accomplishments At One Year Anniversary: Developed resource manuals for local practices to utilize, regarding immunizations, communicable disease, tuberculosis, and lead management. Each participating pediatric provider was given a supply of the “Be A Hero” materials, developed by Buncombe Co., to distribute. This has been an effective means to facilitate valuable conversations with parents and children.

11. Accomplishments continued: Monthly newsletter that includes important changes in recommendations, requirements and immunization laws. Also included, are any current outbreaks or changes in the requirements of CD/VPD reporting as well as education and training opportunities in the field of immunizations and VPD. Held 4 quarterly meetings:  3 of the 5 participating practices have had a provider attend all 4 meetings  4 of the 5 participating practices have had a practice manager or vaccine administrator attend all 4 meetings  Number of attendees have ranged from 13-21, with the highest number attending our last meeting this past February

12. Actions continued o Spoken to local high school’s allied health students o Held a class on immunizations providing child care workers CEUs o Surveyed local OB/GYN on Tdap recommendations and provided patient and provider packets o Promoting NIIW by partnering with local business to give a free frozen custard for kids vaccinated dur ing the month leading up to NIIW. Pictured: Henderson Co. DPH Immunization Staff (on Halloween as immunization heroes)

13. Promotional Flyers of HCIC Events

14. Member Feedback  After the first meeting a survey was sent out to determine: frequency and time of day preferred for meetings, amount of each of the “Be A Hero” materials desired, contact information for other individuals in the practice that should also receive emails.  Three of the five member practices allowed my coworker Justina Hall, RN, BSN and I to have access to their NCIR, enabling us to run benchmark reports, call and send reminders to their kids who are not up to date and help improve their rates. All participating practices have had improvement on their immunization rates and are appreciative of the help.  In the third meeting held Oct. 2015, we took a vote to determine if the members wanted to continue meeting at current frequency or at all, if to continue the newsletter and if it was useful. A unanimous vote to continue as is was made.

15. Feedback, continued  Member physicians attending meetings have requested support and information on:  Local and regional VPD rates  Info/Studies supporting pregnancy dose of Tdap to utilize when presenting to a monthly hospital meeting  Addressing missed opportunities for a well child visit and routine immunizations because of free “sports physicals” that occur in school health clinics  NC immunizing pharmacist laws  Vote taken Feb. 2016 to involve pharmacists, urgent care providers and retail drugstore clinics

16. Outcomes:  2015 Samuel L. Katz, M.D. Excellence in Immunization Award  2015 Henderson County benchmark immunization rate increased 4% and is the highest the county has seen in 15 years.  As of March 2016 no confirmed or probable cases of VPD in Henderson Co.  Last meeting in Feb. 2016 showed our largest turn out to date for a total of 19 attendees.

17. Barriers to Success 1.Limited resources and time 2.Medical community lack of interest or awareness of a problem 3.Lack of participation of members and volunteering for tasks

18. Future Goals and Plans 1.Broaden our membership to include OB/GYN providers, family practice, local hospital administrative staff, and urgent care clinics and pharmacists 2.Hold a parent forum with expert speakers in specialties including: Pediatrics, OB/GYN, Oncology, Autism research, Epidemiology, Parents of children who endured a VPD or the survivor. 3.Host a dinner with Pharm D to discuss the importance of Tdap with OB/GYNs 4.Host a training for local medical offices to be trained on NCIR and storage and handling

19. Goals and Plans Continued: Improve county immunization rates to 80% by next year (currently at 75% for 24month cohort). Work with practices and schools to improve immunization rates with adolescent cohort group. Establish members in Coalition who will advocate within the medical community for increased awareness on the importance of immunizations throughout the life span. Work as a group to establish a unified stance on the requirement of health care professionals to be vaccinated and develop a policy to be used for each participating practice. Begin work on a regional coalition and recruit an individual willing to head that effort. Create a public service announcement for WNC.