1. Raise Your Voice for Meningococcal Disease Vaccination MKT19193

2. Slide 2 Welcome [NAME] [TITLE] [National Association of School Nurses Affiliate]

3. Slide 3 Clinical Overview: Meningococcal Disease Infection caused by the bacterium Neisseria meningitidis 1 —Serotypes A, B, C, Y, and W-135 cause majority of meningococcal disease cases worldwide 2 —Leading cause of bacterial meningitis among US toddlers, children and adolescents Serotypes B, C, and Y most common in US 2 Meningococcal disease can cause meningitis (swelling of the brain or spinal cord) or meningococcemia (blood infection) 3 Vaccination is safe and effective and the best way to help prevent the disease among adolescents 3 References: 1. Centers for Disease Control and Prevention (CDC). Meningococcal disease – New England, 1993 – 1998. MMWR. 1999;48(29):629-633. 2. CDC. Epidemiology and Prevention of Vaccine- Preventable Diseases. Atkinson W, Hamborsky J, McIntyre L, Wolfe S, eds. 10th ed. Washington, D.C.: Public Health Foundation, 2008. 3. CDC. Meningococcal vaccines: what you need to know. http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-mening.pdf. Accessed April 7, 2010.

4. Slide 4 Approximately 1000 to 2600 Americans get meningococcal disease annually 1 —The disease rates peak at 15-19 years of age 2 When meningococcal disease occurs the consequences can be devastating 1 —Fast progressing…can take a life in just a single day 3 —Teens are up to 5 times more likely to die than other age groups 2 —Among survivors, 1 in 5 will suffer permanent complications Amputation, hearing loss, neurological damage, and organ failure 1,4 Early symptoms can resemble the flu, making diagnosis difficult —Symptoms include fever, headache, stiff neck, nausea and vomiting, and rash 5-6 Clinical Overview: Meningococcal Disease References: 1. CDC. Meningococcal vaccines: what you need to know. http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-mening.pdf. Accessed April 7, 2010. 2. Harrison LH, Pass MA, Mendelsohn AB, et al. Invasive meningococcal disease in adolescents and young adults. JAMA. 2001;286:695-699. 3. Erickson LJ, De Wals P, McMahon J, Heim S. Complications of meningococcal disease in college students. Clin Infect Dis. 2001;33:737-739. 4. National Meningitis Association. Overview. http://www.nmaus.org/meningitis. Accessed April 7, 2010. 5. Granoff DM, Harrison LH, Borrow R. Meningococcal vaccines. In: Plotkin SA, Orenstein WA, eds. Vaccines. 5th edition. Philadelphia, Pa: Elsevier Inc; 2008:399-435. 6. National Meningitis Association. Symptoms. http://www.nmaus.org/meningitis/symptoms.htm. Accessed April 7, 2010.

5. Slide 5 Clinical Overview: Meningococcal Disease Spread from person to person through close, personal contact and exchange of respiratory secretions 1 Common everyday activities can put adolescents at increased risk for infection; these activities or risks include: 1-2 —Sharing drinking glasses and eating utensils —Kissing —Living in close quarters —Smoking (or being exposed to smoke) Meningococcal disease can occur at any point during the year —Late-winter and early-spring are when most cases occur 3 References: 1. Granoff DM, Harrison LH, Borrow R. Meningococcal vaccines. In: Plotkin SA, Orenstein WA, eds. Vaccines. 5th edition. Philadelphia, Pa: Elsevier Inc; 2008:399-435. 2. National Meningitis Association. Who is at risk. http://www.nmaus.org/meningitis/who-is-at-risk.htm. April 7, 2010. 3. CDC. Epidemiology and Prevention of Vaccine-Preventable Diseases. Atkinson W, Hamborsky J, McIntyre L, Wolfe S, eds. 10th ed. Washington, D.C.: Public Health Foundation, 2008.

6. Slide 6 Clinical Overview: Meningococcal Disease Once diagnosed with meningococcal disease, early antibiotic treatment is critical 1 —Even with treatment, meningococcal disease can kill an otherwise healthy young person 1-2 Close contacts should also receive preventive antibiotics 1 —Family members, close friends References: 1. Rosenstein NE, et al. Meningococcal disease. N Engl J Med. 2001;344(18):1378. 2. Erickson LJ, De Wals P, McMahon J, Heim S. Complications of meningococcal disease in college students. Clin Infect Dis. 2001;33:737-739.

7. Slide 7 Vaccination – The Best Protection Vaccination continues to be the best way to prevent meningococcal disease —Helps protect against 4 of the 5 primary serotypes (A, C, Y, and W-135) 1 Centers for Disease Control and Prevention (CDC) recommends routine vaccination for: 2-3 —Adolescents 11-18 years of age —College freshmen living in dormitories —Children 2 through 10 years of age at increased risk —Anyone 2 through 10 years of age if elected by parent or health- care provider References: 1. CDC. Meningococcal vaccines: what you need to know. http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-mening.pdf. Accessed April 7, 2010. 2. CDC. Notice to readers: revised recommendations of the ACIP to vaccinate all persons aged 11-18 years with meningococcal conjugate vaccine. MMWR. 2007;56(31):794-795. 3. CDC. Notice to readers: recommendation from the ACIP for use of quadrivalent meningococcal conjugate vaccine (MCV4) in children aged 2-10 years at increased risk for invasive meningococcal disease. MMWR. 2007;56(48):1265- 1266.

8. Slide 8 Vaccination Rates Alarmingly Low In 2008, only 41.8% of teens 13-17 years of age received the recommended meningococcal vaccine 1 —Far from the CDC’s goal of a 90% immunization rate 2 Florida has a 33.6% rate of meningococcal vaccination among adolescents 13-17 years of age References: 1. CDC. National Immunization Survey (NIS) adolescents/teens only: coverage with Individual vaccines. http://www.cdc.gov/vaccines/stats-surv/nisteen/tables/08/tab01_iap.xls. Accessed April 7, 2010. 2. CDC. National, state, and local area vaccination coverage among adolescents aged 13-17 Years - United States, 2008. MMWR. 2009;58(36);997-1001.

9. Slide 9 Why Aren’t More Teens Getting Vaccinated? 1-3 Many parents and students still unaware of disease, vaccine Fewer health maintenance visits Missed immunization opportunities Lack of population-based immunization registries that include adolescents Low public awareness about adolescent immunization coverage, recommendations, and available vaccinations Misperceptions about vaccine safety References: 1. National Foundation for Infectious Diseases (NFID). Meningococcal vaccination: improving rates in adolescents and reducing racial, ethnic and socioeconomic disparities, 2008. http://stopmeningitis.nfidinitiatives.org/pdf/CTA.pdf. Accessed April 7, 2010. 2. Oster NV, et al. Barriers to adolescent immunization: a survey of family physicians and pediatricians. J Am Board Fam Pract. 2005;18(1):13. 3. Freed GL, Clark SJ, Butchart AT. Parental vaccine safety concerns in 2009. Pediatrics. 2010;10:654-659.

10. Slide 10 Vaccination Requirements in Elementary and Secondary Schools 1-4 References: 1. Immunization Action Coalition. Meningococcal state mandates for elementary and secondary schools. http://www.immunize.org/laws/menin_sec.asp. Accessed April 7, 2010. 2. New York State Department of Health. New York recommended childhood and adolescent immunization schedule. http://www.health.state.ny.us/publications/2378.pdf. Accessed April 7, 2010. 3. Indiana State Department of Health. 2010-2011 school year Indiana State Department of Health (ISDH) school immunization requirements quick reference guide. http://www.hse.k12.in.us/PDF/clinicalServices/Immunization%20Chart.pdf. Accessed April 7, 2010. 4. Michigan Department of Community Health. New communicable disease rules 2010-2011 school reporting year. http://www.swartzcreek.org/Pupil/SS_NewSchReqmnts1-10.pdf. Accessed April 7, 2010. 5. State of California Legislative Counsel. California Health and Safety Code. http://www.leginfo.ca.gov/cgi-bin/waisgate?WAISdocID=26994629975+0+0+0&WAISaction=retrieve. Accessed May 7, 2010. States requiring vaccination States requiring education

11. Slide 11 School Nurses: Helping to Prevent Meningococcal Disease School nurses play an instrumental role in raising awareness about meningococcal disease and vaccination —Leading advocate in adolescent health —Direct reach to adolescents, parents, and families —Trusted source of health information Parents rely on school nurses for information surrounding the health and well-being of their children

12. Slide 12 Become a “Voice” of Meningitis A public awareness campaign by the National Association of School Nurses (NASN) in collaboration with sanofi pasteur —Gives “voice” to meningitis through sharing stories of those personally affected by the disease Parents Disease survivors School nurses How You Can Help Support Educational Efforts in Florida

13. Slide 13 Voices of Meningitis Objectives Empower school nurses to further educate parents, teens —Parents rely on school nurses for health information Educate parents and teens about dangers of meningococcal disease, encourage them to seek vaccination Encourage dialog between parents, school nurses, and other health-care providers about meningococcal vaccination

14. Slide 14 Voices of Meningitis Challenge “Challenges” school nurses to implement meningococcal educational efforts Provides school nurses with resources and strategies Recognizes school nurses for their educational efforts —Highlights successes in raising awareness of meningococcal disease and prevention Fosters sharing of ideas and strategies nationwide

15. Slide 15 Voices of Meningitis Challenge Challenge “Champions” to offer guidance and support Great Plains Mid-Atlantic Midwest New England South Southeast Southwest West West Region Champion: Cheryl Sampson; csampson@cvsd.org Great Plains Region Champion: Carol Tucker; carol.tucker@agps.orgcarol.tucker@agps.org and Polly Witt; pwitt@gckschools.com pwitt@gckschools.com Midwest Region Champion: Cindy Hiltz; cynthia.hiltz@anoka.k12.mn.us New England Region Champion: Linda Twardowski; linda_5208@cox.net Southwest Region Champion: Linda Hummingbird; lhummingbird@sfis.k12.nm.us Mid-Atlantic Region Champion: Beth Mattey; elizabeth.mattey@bsd.k12.de.us Southeast Region Champion: Jennifer Garrett; jgarrett@maconnc.org and Kathleen Rose; flschoolrn@embarqmail.com flschoolrn@embarqmail.com South Region Champion: Mary Glasscock; mary.glasscock@arkansas.govmary.glasscock@arkansas.gov, and Shawn Smith; shawnsmith_ges@yahoo.com; and Michelle Keith; shawnsmith_ges@yahoo.com michellek@battlegroundacademy.org

16. Slide 16 Voices of Meningitis Challenge Implementation Guide —Provides ideas to initiate meningococcal disease awareness programming within communities Educational materials —Posters —Brochure —Fact sheet —Report card sticker —Parent letters —Media materials —Educational videos Complimentary materials available on VoicesOfMeningitis.org

17. Slide 17 Voices of Meningitis Challenge Submit case studies of all awareness activities conducted —Case studies featured on the National Association of School Nurses (NASN) Web site —Serves as repository of ideas and strategies for school nurses nationwide Five case studies selected to be presented during the 2011 NASN Annual Conference Online submission form on NASN Web site

18. Slide 18 Tips to Use Online Resources Parent Mailings and Report Cards —Send a Voices of Meningitis brochure or letter home to your students’ parents School Assembly —Discuss meningitis during a school assembly or pep rally —Show a Voices of Meningitis educational video Local Parent Teacher Association or Organization Partnership —Host a presentation during a regular scheduled meeting; distribute materials Athletic Department Partnership —Involve athletic directors to distribute Voices of Meningitis fact sheets with sports physical forms

19. Slide 19 Happy (and Healthy) Graduation —Send information home with order forms for yearbooks, class rings, cap and gown, etc. —Set up a table at college fairs Online vehicles —Distribute a note about meningitis vaccination via your school’s parent listserv —Use the Voices of Meningitis widget to link your school’s Web site with the campaign site Visit VoicesOfMeningitis.org —Includes more information and ideas Tips to Use Online Resources (con’t)

20. Slide 20 Questions?