chris finley and karen halverson ensuring herd immunity immunization rules for schools and child...
TRANSCRIPT
Chris Finley and Karen Halverson
Ensuring Herd ImmunityImmunization Rules for Schools and Child Care
Today’s objectives
Rationale for immunization regulations
Reporting requirements
Statewide variations in rates
Addressing challenges
State Immunization Rules
Prevent disease transmission
Reduce risk in group settings
Support herd immunity
Herd Immunity
Measles at Vermont’s borders
Massachusetts, New York and New Hampshire
50 cases 1/1/11-10/8/11
Only religious and medical exemptions allowed
No philosophic exemptions
Measles at Vermont’s borders
Quebec
745 cases 4/3/11 -10/5/11
11% of cases hospitalized
No vaccination requirements for school
Development of Immunization Rules
Specific state statutes
Rules provide details for implementation
Defined process for passage of rules
Opportunity for public input Reviewed by two committees
Vermont’s Immunization Rules
Immunizations required for enrollment
Application in child care and school settings
Annual reporting period
Vermont Recommended Child and Teen Vaccination Schedule
Child Care Requirements
Who do the rules apply to?
How are these different than school rules?
Who completes child care reports?
Information for Child Care Providers Put in pictures of 2 brochures and manual
School Requirements
Align with Advisory Committee on Immunization Practices (ACIP) recommendations
Allow for exemptions
Provisional admittance limit of one year
Vermont Kindergarten Immunization Exemptions and Provisional Status
0%
2%
4%
6%
8%
10%
12%
14%
'10-11'09-10'08-09'07-08'06-07'05-06'04-05'03-04'02-03'01-02'00-01
Year of Enrollment
Per
cent
of S
tude
nts
Sur
veye
d
philosophic exemptions (%)provisional status (%)
Varicella (2 doses) and hepatitis B requirement added to school rules in 2008.
Unimmunized KindergartenersVermont 2010-2011
1% 0.2%
5%
10.7%
0%
2%
4%
6%
8%
10%
12%
medicalexemptions (%)
religiousexemptions (%)
philosophicexemptions (%)
provisionalstatus (%)
Kindergarten data 2010-11
Percent of Vermont Schools with Provisional Admittance
36%28% 31%
5%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Fully compliant Low provisional High provisional Very High provisional
Measles outbreak risk in Vermont
Herd immunity threshold for measles:95%
2010-11 kindergarteners with 2 doses MMR:
90.9%
Schools with coverage below 95%:136
School Site Visits January - May 2011
Pilot visits to selected schools by Immunization Program staff
Sept 2011 - May 2012 Site visits to all schools conducted by District Office school liaisons
Sept 2011 - May2012 Quality improvement project visits for 15 schools conducted by VCHIP/VDH
Increasing Compliance with Vermont Vaccine Requirements
Utilize electronic data sources VT Immunization Registry
school health software programs
Increasing Compliance with Vermont Vaccine Requirements
Outreach
at enrollment
before vacation and holiday breaks
newsletters, websites, PTO
Immunization Program Support
Vermont Immunization Program1-800-640-4374
District Office staffSchool liaisonImmunization Designee