2.  Prevents 14 million cases of disease in the US each year  Objectives reflect a mobile world society  People continue to contract diseases that are vaccine preventable

4.  Types of flu vaccines 3  Importance for pregnant women and babies 4  Safety of the flu vaccine 4  Who can receive the vaccine 4 http://www.proteanservices.com/2009/08/why-you-should- get-both-the-seasonal-flu-and-the-h1n1-flu-vaccine/

5. During the 2012-2013 early flu season:  47.3% of pregnant women were vaccinated 5  Safety concerns were the main barrier 5  Remaining below the 80% target 5  Text4baby program 6

7. During the 2009-2010 flu season:  53.3% of pregnant women were vaccinated 7  Text4baby and Washington DOH partnership 8,9  Washington DOH letter to physicians (M. Hayes, personal communication, January 31, 2011).  Vaccine shortage and suspension of mercury limits 10

8.  Current availability of vaccine 11  Whatcom County H.D. community flu shot clinic 39  Text4baby on WTA buses 8 http://schedule.sxsw.com/2012/events/event_IAP10536

9.  Pregnancy increases risk for flu complications 4  Increased hospitalizations for infants 12  Health care providers recommending vaccination 5  Increased accurate knowledge 5, (G. Stream & associates, personal communication, December 5, 2011). › Faces of Influenza grassroots campaign 13

11.  “Whooping cough” 14  Most commonly affects infants, young children 14  Many infants infected by family members 15  Best prevention is vaccination 14,15,16 › DTaP vs. Tdap  http://www.youtube.com/watch?v=wuvn- vp5InE 23 http://www.youtube.com/watch?v=wuvn- vp5InE

13.  Incidence of infant pertussis 29  Recent outbreak activity 26  Primary goal of outbreak control 26  National campaigns 29 http://multivu.prnewswire.com/mnr/soundsofpertussi s/50717/

14.  Pertussis epidemic in April 2012 17  Highest rate in children under age 1 17  Improvements after 2012 › Continued push for vaccinations 19 › WA DOH translated materials on website 19

16.  Skagit and Whatcom counties 17  Pertussis vaccine opt-out rate 21  Budget cuts 22  GIFT Tdap vaccine program 20 http://vaccinenewsdaily.com/medical_countermeasures/320913-tdap- vaccine-declared-safe-for-adults-over-65/

19.  Infant hospitalization 27  Acceleration of administration of DTaP 28  Offering Tdap for caregivers at 2 week check up 30

21.  What is tuberculosis?  Spread through the air  Latent vs. active

22. During 2011:  3.4 cases of TB per 100,000 people  Decline compared to 2010  Foreign born vs. U.S. born citizens

24. During 2011:  3.0 cases per 100,000 people  Foreign born citizens  Multi-drug resistant  Age as a factor

25. Cases Per 100,000

26.  Ann Rushing  3.0 active cases per 100,000 people in 2012  90% latent, 10% active  Current issue: multi drug resistance  Highest priority: active TB cases

27.  Screening of immigrants seeking US citizenship 35  Workplace safety and awareness 36,37  Treatment methods 34  Western Washington University policy 34