1. Bringin' Them Out of the Woodworks: H1N1 and NYSIIS Participation
Loretta A. Santilli, M.P.H
Program Manager
New York State Immunization Information System (NYSIIS)
New York State Department of Health (NYSDOH)
(518)

2. Acknowledgements Co-Authors
Debra Blog, MD, MPH, Director NYSDOH Bureau of Immunization
Katie Reed, MPA, Project Manager HP Enterprise Services, LLC
The NYSIIS Team who went “above and beyond” during the H1N1 campaign:
Barb, Diane, Jean, Laura, Logan, Lori, Megan, Michael, and Munyaradzi

3. NYSIIS
Public Health Law mandated provider reporting as of January 1, 2008 for immunizations given to children less than 19 years of age (including immunization histories)
Info for persons 19 years of age or older can be added with written consent
New web-based system serving New York State (outside of New York City)
Officially launched February 2008

4. Key Statistics As of April 1, 2010 NYSIIS contains:
3.1 million patients
35.1 million immunizations
9,100+ individual users
3,100 health care provider organizations
1,450+ schools
78.2 % of NYS children (outside of NYC) less than 6 years of age have 2 or more shots in NYSIIS

5. How’d We Get Here?
We designed a two-year multi-faceted implementation strategy to maximize provider participation. Focused on:
Communication and outreach
Training and education
Technological support

6. What’s the Problem?
At the beginning of year two (2009), we observed our rate of growth slowing slightly.
Then, at around 15 months (April 2009), the first cases of the novel H1N1 influenza pandemic emerged.
Provider outreach activities were significantly impacted due to redirected team efforts.
Concern that provider participation levels (new and existing) would plateau due to increased clinical activities in provider offices. 

7. How’d We Solve It?
Enhanced NYSIIS infrastructure to support H1N1 data collection and reporting
Added Countermeasure and Response Administration (CRA) module to track by age groups AND priority groups
Added new vaccine codes and established independent H1N1 schedule to assist with tracking second doses
Highlighted existing reminder recall features in NYSIIS
Encouraged use of existing inventory module for tracking doses wasted, expired, recalled

8. How’d We Solve It? (2)
Integrated NYSIIS into H1N1 vaccine registration process
Reminded of PHL requirement for children – incorporated into provider agreement
Strongly encouraged for adult providers
Pointed directly to NYSIIS training page at end of registration process
Linked H1N1 PIN to NYSIIS Org Id for vaccine accountability (doses administered vs. shipped)

9. How’d We Solve It? (3)
Communication
Communication!

10. Results
How’d We Do?

11. Provider Participation in NYSIIS By Month, January 2009 – April 2010
Percent of Known Providers Participating in NYSIIS

12. NYSIIS and H1N1
From April 1, 2009 to April 1, 2010:
1,212 new organizations and 3,391 new users were added.
Including non-traditional participants such as occupational health and Ob-Gyns
993,000 new patients and 12.7 million new immunizations were added.
including nearly 1 million doses of H1N1
The percentage of children less than six years of age with two or more immunizations in NYSIIS increased from 56.2 % to 78.2%. 

13. 12/19/2019
Percent of Children Less Than 6 Years of Age with Two or More Shots in NYSIIS* New York State (outside of New York City)
04/01/2010
*New York State Immunization Information System **Based on Claritas population estimates for 2008 (Jan08-Nov08) and 2009 (Jan09-present).
Percent Participating**

15. P.S. - Other Ways NYSIIS Contributed to the H1N1 Response
Adverse event monitoring
Exchanged info with 3 health plans (Aetna, Cigna, Humana) to compare immunization history to health care utilization data to monitor potential adverse events (miscarriages, GBS).
Evaluation project underway
Did different vaccination strategies in counties impact H1N1 immunization coverage rates in children?

16. Conclusion
The availability of NYSIIS was critical for providers to track patient immunization and assure vaccine accountability and provides a valuable data set for the public health analyses necessary in responding to an event of this magnitude.
“Nothin’ like a good pandemic to bring ‘em outta da woodworks!”

17. Q & A