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Villages of Oriole, FL, United States

Lindley M.C.,National Center for Immunization and Respiratory Diseases | Lorick S.A.,National Center for Immunization and Respiratory Diseases | Geevarughese A.,Bureau of Immunization | Lee S.-J.,University of California at San Francisco | And 4 more authors.
American Journal of Preventive Medicine | Year: 2013

Background Methods of measuring influenza vaccination of healthcare personnel (HCP) vary substantially, as do the groups of HCP that are included in any given set of measurements. Thus, comparison of vaccination rates across healthcare facilities is difficult. Purpose The goal of the study was to determine the feasibility of implementing a standardized measure for reporting HCP influenza vaccination data in various types of healthcare facilities. Methods A total of 318 facilities recruited in four U.S. jurisdictions agreed to participate in the evaluation, including hospitals, long-term care facilities, dialysis clinics, ambulatory surgery centers, and physician practices. HCP in participating facilities were categorized as employees, credentialed non-employees, or other non-employees using standard definitions. Data were gathered using cross-sectional web-based surveys completed at three intervals between October 2010 and May 2011; data were analyzed in February 2012. Results 234 facilities (74%) completed all three surveys. Most facilities could report on-site employee vaccination; almost one third could not provide complete data on HCP vaccinated outside the facility, contraindications, or declinations, primarily due to missing non-employee data. Inability to determine vaccination status of credentialed and other non-employees was cited as a major barrier to measure implementation by 24% and 27% of respondents, respectively. Conclusions Using the measure to report employee vaccination status was feasible for most facilities; tracking non-employee HCP was more challenging. Based on evaluation findings, the measure was revised to limit the types of non-employees included. Although the revised measure is less comprehensive, it is more likely to produce valid vaccination coverage estimates. Use of this standardized measure can inform quality improvement efforts and facilitate comparison of HCP influenza vaccination among facilities. © 2013 American Journal of Preventive Medicine.

Rinchiuso-Hasselmann A.,Office of Emergency Preparedness and Response | McKay R.L.,Office of Emergency Preparedness and Response | Williams C.A.,Office of Emergency Preparedness and Response | Starr D.T.,Office of Emergency Preparedness and Response | And 4 more authors.
Biosecurity and Bioterrorism | Year: 2011

In fall 2009, the New York City Department of Health and Mental Hygiene (DOHMH) operated 58 points of dispensing (PODs) over 5 weekends to provide influenza A (H1N1) 2009 monovalent vaccination to New Yorkers. Up to 7 sites were opened each day across the 5 boroughs, with almost 50,000 New Yorkers being vaccinated. The policies and protocols used were based on those developed for New York City's POD Plan, the cornerstone of the city's mass prophylaxis planning. Before the H1N1 experience, NYC had not opened more than 5 PODs simultaneously and had only experienced the higher patient volume seen with the H1N1 PODs on 1 prior occasion. Therefore, DOHMH identified factors that contributed to the success of POD operations, as well as areas for improvement to inform future mass prophylaxis planning and response. Though this was a relatively small-scale, preplanned operation, during which a maximum of 7 PODs were operated on a given day, the findings have implications for larger-scale mass prophylaxis planning for emergencies. Copyright 2011, Mary Ann Liebert, Inc.

Metroka A.E.,Bureau of Immunization | Papadouka V.,Bureau of Immunization | Ternier A.,Bureau of Immunization | Zucker J.R.,Bureau of Immunization | Zucker J.R.,Centers for Disease Control and Prevention
Public Health Reports | Year: 2016

Objective. We compared the quality of data reported to New York City’s immunization information system, the Citywide Immunization Registry (CIR), through its real-time Health Level 7 (HL7) Web service from electronic health records (EHRs), with data submitted through other methods. Methods. We stratified immunizations administered and reported to the CIR in 2014 for patients aged 0–18 years by reporting method: (1) sending HL7 messages from EHRs through the Web service, (2) manual data entry, and (3) upload of a non-standard flat file from EHRs. We assessed completeness of reporting by measuring the percentage of immunizations reported with lot number, manufacturer, and Vaccines for Children (VFC) program eligibility. We assessed timeliness of reporting by determining the number of days from date of administration to date entered into the CIR. Results. HL7 reporting accounted for the largest percentage (46.3%) of the 3.8 million immunizations reported in 2014. Of immunizations reported using HL7, 97.9% included the lot number and 92.6% included the manufacturer, compared with 50.4% and 48.0% for manual entry, and 65.9% and 48.8% for non-standard flat file, respectively. VFC eligibility was 96.9% complete when reported by manual data entry, 95.3% complete for HL7 reporting, and 87.2% complete for non-standard flat file reporting. Of the three reporting methods, HL7 was the most timely: 77.6% of immunizations were reported by HL7 in <1 day, compared with 53.6% of immunizations reported through manual data entry and 18.1% of immunizations reported through non-standard flat file. Conclusion. HL7 reporting from EHRs resulted in more complete and timely data in the CIR compared with other reporting methods. Providing resources to facilitate HL7 reporting from EHRs to immunization information systems to increase data quality should be a priority for public health. © 2016, Association of Schools of Public Health. All rights reserved.

Doll M.K.,Bureau of Immunization | Rosen J.B.,Bureau of Immunization | Bialek S.R.,Centers for Disease Control and Prevention | Szeto H.,The New School | Zimmerman C.M.,Bureau of Immunization
American Journal of Public Health | Year: 2015

Objectives: We assessed coverage for 2-dose varicella vaccination, which is not required for school entry, among New York City public school students and examined characteristics associated with receipt of 2 doses. Methods: We measured receipt of either at least 1 or 2 doses of varicella vaccine among students aged 4 years and older in a sample of 336 public schools (n = 223 864 students) during the 2010 to 2011 school year. Data came from merged student vaccination records from 2 administrative data systems. We conducted multivariable regression to assess associations of age, gender, race/ethnicity, and school location with 2-dose prevalence. Results: Coverage with at least 1 varicella dose was 96.2% (95% confidence interval [CI] = 96.2%, 96.3%); coverage with at least 2 doses was 64.8% (95% CI = 64.6%, 64.9%). Increasing student age, non-Hispanic White race/ethnicity, and attendance at school in Staten Island were associated with lower 2-dose coverage. Conclusions: A 2-dose varicella vaccine requirement for school entry would likely improve 2-dose coverage, eliminate coverage disparities, and prevent disease.

Livingston K.A.,Centers for Disease Control | Rosen J.B.,Bureau of Immunization | Zucker J.R.,Bureau of Immunization | Zucker J.R.,Centers for Disease Control and Prevention | Zimmerman C.M.,Bureau of Immunization
Vaccine | Year: 2014

Background and objectives: Mumps outbreaks have been reported among vaccinated populations, and declining mumps vaccine effectiveness (VE) has been suggested as one possible cause. During a large mumps outbreak in New York City, we assessed: (1) VE of measles-mumps-rubella vaccine (MMR) against mumps and (2) risk factors for acquiring mumps in households. Methods: Cases of mumps were investigated using standard methods. Additional information on disease and vaccination status of household contacts was collected. Case households completed follow-up phone interviews 78-198 days after initial investigation to ascertain additional cases. Mumps cases meeting the study case definition were included in the analysis. Risk factors for mumps were assessed, and VE was calculated using secondary household attack rates. Results: Three hundred and eleven households with 2176 residents were included in the analysis. The median age of residents was 13 years (range <1-85), and 462 (21.2%) residents met the study mumps case definition. Among 7-17 year olds, 89.7% received one or more doses of MMR vaccine, with 76.7% receiving two doses. Young adults aged 10-14 years (OR. = 2.4, CI. = 1.3-4.7) and 15-19 years (OR. = 2.5, CI. = 1.3-5.0) were at highest risk of mumps. The overall 2-dose VE for secondary contacts aged five and older was 86.3% (CI 63.3-94.9). Conclusions: The two-dose effectiveness of MMR vaccine against mumps was 86.3%, consistent with other published mumps VE estimates. Many factors likely contributed to this outbreak. Suboptimal MMR coverage in the affected population combined with VE may not have conferred adequate immunity to prevent transmission and may have contributed to this outbreak. Achieving high MMR coverage remains the best available strategy for prevention of mumps outbreaks. © 2013 Elsevier Ltd.

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