Vax facts : e-news from the North Carolina Immunization Branch

              E-NEWS FROM THE NORTH CAROLINA IMMUNIZATION BRANCH
May 3, 2011 Volume 2, Number 5
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What’s Going On At the Immunization Branch?
2011 North Carolina Immunization Conference: Making a Better Tomorrow
North Carolina immunization providers prepare to get educated, get inspired and get continuing education
credits! The 2011 North Carolina Immunization Conference starts August 10 at the Koury Convention
Center in Greensboro. If you’ve been before, you know the hotel and conference center are centrally located,
comfortable and adjacent to the mall! Join your colleagues from around the state to swap stories of success
and frustration. Learn what works, what doesn’t and why. Return to your office ready to implement North
Carolina Immunization Program requirements with ease and confidence.
Special guest speakers at this year’s conference include; Anne Schuchat, MD director of CDC's National Center
for Immunization and Respiratory Diseases (NCIRD); Andrew Kroger MD, MPH from the NCIRD; Donna
Weaver, RN, MN from the NCIRD; Alison Singer, Founder and President of the Autism Science Foundation and
Jeffrey Engel, M.D. State Health Director of North Carolina. Register and view updates online.
Samuel L. Katz, M.D. Excellence in Immunization Award
Dr. Sam Katz is an immunization champion and hero to millions across the globe. In the 1960s he worked
with Nobel laureate John F. Enders to develop the measles vaccine. Thanks to their efforts, a disease that
used to impact almost every person in the U.S. and killed hundreds of children every year in our country, is
now rare. This extraordinary accomplishment was one of many achievements for Dr. Katz. He focused his
career on infectious disease research, vaccine development and policy. He served as the chairman of Duke
University’s Department of Pediatrics for more than two decades. He serves as a member of numerous
immunization policy boards including the CDC’s Advisory Committee on Immunization Practices and North
Carolina’s Immunization Advisory Committee. Now in his 80s, Dr. Katz continues to impact lives for the
better. He and his wife, Dr. Catherine Wilfert, travel the globe working on AIDS research and relief efforts.
For these reasons and many more, the North Carolina Immunization Branch salutes Dr. Katz by presenting an
award named in his honor. The Samuel L. Katz Excellence in Immunization Award recognizes an outstanding
individual or agency in North Carolina who has developed innovative strategies, projects or programs to
increase adult or childhood immunization coverage rates.
If you know someone who deserves recognition for their work to further immunizations in North Carolina,
please let us know by submitting a nomination form for the 2011 Katz Excellence in Immunization Award.
We’ll recognize the award recipient during the 2011 North Carolina Immunization Conference this August in
Greensboro. You’ll find a nomination packet online at www.immunizenc.com/conference.htm The deadline
for submission is June 20, 2011.
Immunization Advisory Committee
Highlights from our last meeting
Staff from the Immunization Branch meet regularly with a voluntary council of clinical, legal and
programmatic advisors to discuss immunization issues. The group serves to provide advice and guidance to
the Department of Health and Human Services regarding the most appropriate application of available
immunologic agents for effective communicable disease control and prevention in the North Carolina
population. The committee provides advice for the control of diseases for which a vaccine is recommended by
the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices.
The last meeting of the Immunization Advisory Committee (IAC) was held March 23, 2010 in Raleigh.
Committee members discussed presentations from the February meeting of the Advisory Committee on
Immunization Practices, public health bills being debated in the North Carolina General Assembly, the 2010-
2011 influenza season including state-supplied flu vaccine distribution and uptake and other issues.
Immunization providers and representatives from pharmaceutical companies are welcome to attend these
meetings. Just let us know if you plan to attend. The next meeting will take place on September 28, 2011 in
Raleigh.
NCIR Tips
Accountability Reports Q&A
Earlier this year the NCIR Vaccine Accountability Report was made available to NCIR Administrators. Here are
answers to some common questions administrators have asked us:
Question: How is the percentage of accountability determined?
Answer: The total dollar value of doses received (X) from the state for the generated report time period is
divided by the dollar value of under/over accounted doses (Y) plus the dollar value of error corrected doses
(Z) to generate the percentage of unaccounted for vaccine (A). The formula looks like this: X/Y+Z=A
For example:
If during the period from May 1, 2011 to May 31, 2011 the amount of doses your practice received from the
state equaled $6500 and you had 2 unaccounted for doses of hepatitis B vaccine (2 doses are worth $20.70)
and you error corrected 1 dose of Rotateq vaccine (1 dose is worth $59.76) your percentage of accountability
would be:
6500/20.70+59.76 = 81 or 0.81 percent
You’re percentage of accountability is far below the upper limit of 5 percent. Congratulations!
Question: If I know there are unaccounted doses, but they do not show up in the error corrected column of
the accountability report, where can I find them?
Answer: Chances are you have expired vaccine in your inventory. Look in the request transaction summary
report to confirm this. You’ll find the request transaction summary report just above the vaccine
accountability report under the Inventory column on the left hand side of your screen. It looks like this:
In the coming weeks the Branch will begin contacting practices which have a rate of 5 percent or more of
unaccounted for state-supplied vaccine. We’ll work with these practices to ensure all vaccine is accounted for
correctly.
Online NCIR Classes
Join us for free online NCIR training sessions on the second Wednesday of each month at 9 a.m. with a repeat
session at noon. There is no need to pre-register. Simply log on to the NCIR and look under the
Announcements section for a link to join the sessions. You’ll also need to dial in via telephone to hear the
presentation - just remember to mute your phone! Each session is approximately 30 minutes.
Upcoming online training sessions:
Date Time Title Additional Information
May 11, 2011 9 a.m.
and 12
p.m.
Transaction Summary
Reports and VFC
Report
Learn the ins and outs of running and
interpreting these useful reports.
Clinician’s Corner
NC EDSS and Communicable Disease Reporting
The North Carolina Electronic Disease Surveillance System (or NC EDSS, sometimes pronounced “neds”) has
changed the way we report and track infectious diseases in North Carolina. The online tool allows the Division
of Public Health to exchange and report data to local health departments and others. The system makes it
easier to track outbreaks of communicable diseases across the state.
As soon as a provider suspects a patient has a reportable disease they should contact their Local Health
Department by phone. The LHD then works with the provider and the Immunization Branch to track diseases
including pertussis, measles, mumps, rubella, congenital rubella syndrome, tetanus, diphtheria, polio and
perinatal hepatitis B.
There are particular protocols to follow in reporting and tracking each disease. You can find guidance online.
For example, this guide includes tips on entering pertussis reports. It contains this important clinical note on
pertussis reporting even when the incorrect labs have been ordered:
No serologic method for diagnosis of pertussis has been validated between laboratories or
has been approved for diagnostic use in the U.S., but there are many physicians that collect
these instead of the approved NP Swab for PCR and culture. Positive IgM and IgG for pertussis are
reported and require follow-up to establish if the patient met the clinical case definition for pertussis
or not. Serology lab cases are reported as probable if they meet clinical case definition. Depending on
how much time has passed, there may still be a need to do investigation, treatment of close contacts,
and surveillance. You may discover secondary cases that can have an NP swab for PCR and culture.
For reporting, if you find the patient with serologies did meet case definition, follow the steps above
and report as a probable case. If the patient did not meet criteria for reporting you need to document
that fact in the clinical package by either answering “no” to the question “Is / was patient
symptomatic?” or by answering “no” to enough of the questions in the clinical package to show that
the patient did NOT meet clinical case definition.
Review the North Carolina Communicable Disease Manual, training webinars for NC EDSS, and a list of NC
EDSS resources and guidelines for more details.
Kudos
The North Carolina Immunization Branch wishes to congratulate a few immunization champions who are
moving on to new endeavors as they begin retirement.
Janice Parham, Haywood County Health Department
In a few weeks Janice Parham will retire from the Haywood County Health Department after more than 30
years of dedicated service. She’s focused much of her career on immunization tracking. She reaches out to
her colleagues, providers in the county and to the public to ensure children are getting their immunizations on
time.
Colleagues say Janice is an invaluable member of the team. She’s known for her dedication to ensuring the
county’s immunization rates are high. She’s relied upon as a great resource to talk through immunization
questions with, and she ensures the staff is all on the same page. Janice did an outstanding job organizing
the county’s supply of VFC vaccine as the UCVDP program transitioned into the NCIP program. And her
influence reaches beyond the health department. When a private provider in Haywood County has a question
or problem with the NCIR, Janice is usually the first person they call. Her dedication and expertise will be
missed. A coworker says, “It will hurt us when she leaves. We’ll get by, but it won’t be easy.”
Kudos to you, Janice Parham, for your service to families in Haywood County! The Immunization Branch
agrees with one of your colleagues - “Even if the community doesn’t realize it, they’ve had an advocate for
their children.”
Pat Perry, Wilson County Health Department
Congratulations to recently retired Pat Perry, R.N. who worked as the Immunization Coordinator for Wilson
County for many years. Pat was known for her expertise and her extraordinary commitment to tracking
immunizations in children across Wilson County. She is past recipient of the Samuel L. Katz Excellence in
Immunization Award. Pat spent much of her time traveling to provider’s offices, child cares and into homes to
ensure children were up to date on their immunizations. She also organized clinics for Tdap and influenza.
Pat is greatly missed at the health department. As one coworker put it, “She knows her stuff!” Kudos to Pat
Perry for dedicating part of her career to immunizations and for making such a huge impact in the health of
children in her community!
Donna Blue, Moore County Health Department
Donna Blue served as the Director of Nursing for the Moore County Health Department for more than two
decades. When she retired recently, coworkers knew it would be difficult to fill her shoes. She was an expert
on the NCIR and a true champion for immunizations. She was known for her strong commitment to family
and her dedication to public health. She will be missed! Kudos to Donna Blue for working so hard during her
career to promote immunizations and public health. The citizens of Moore County and beyond owe her a debt
of gratitude!
If you would like to recognize an immunization champion with a mention in the Kudos section of Vax Facts,
send an email to Amy Caruso at amy.caruso@dhhs.nc.gov.
News You Can Use
The 2011 Edition of the Pink Book: The 12th Edition of Epidemiology and Prevention of Vaccine-
Preventable Diseases is now available. You can order your copy online or download an electronic copy for
free. No provider office should be without it!
New Website: The federal government has launched a new website dedicated to vaccines. Log on to
www.vaccines.gov to learn more.
New Tdap Recommendations for Healthcare Workers: The CDC’s Advisory Committee on Immunization
Practices has adopted new recommendations on Tdap for healthcare workers. The provisional
recommendations state:
 The ACIP recommends that all healthcare personnel (HCP), regardless of age, should receive a single
dose of Tdap as soon as feasible if they have not previously received Tdap and regardless of the time
since last Td dose.
 Tdap is not currently licensed for multiple administrations. After receipt of Tdap, HCP should receive
routine booster immunization against tetanus and diphtheria according to previously published
guidelines.
 Hospitals* and ambulatory-care facilities should provide Tdap for HCP and use approaches that
maximize vaccination rates (e.g., education about the benefits of vaccination, convenient access, and
the provision of Tdap at no charge).
*Hospitals, as defined by the Joint Commission on Accreditation of Healthcare Organizations, do not include
long-term–care facilities such as nursing homes, skilled-nursing facilities, or rehabilitation and convalescent
care facilities. Ambulatory-care settings include all outpatient and walk-in facilities.
The full provisional recommendations are available online.
State supplied Tdap vaccine is available to healthcare workers in some settings. Refer to the NCIP Coverage
Criteria for complete details.
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Contact Information
NC Immunization Branch ● 1917 Mail Service Center ● Raleigh, NC 27699
Phone: 919-707-5550 ● Fax: 919-870-4824 ● Website: www.immunizenc.com
Help Desk ● Phone: 877-873-6247 ● Fax: 800-544-3058 ● Email: ncirhelp@dhhs.nc.gov