Galveston County Health Galveston County Health DistrictDistrict

Immunization ProgramsImmunization Programs

HistoryHistory

• 1968- 1970 Immunizations given 2 half-1968- 1970 Immunizations given 2 half-days a week on the mainland by a TDH days a week on the mainland by a TDH nurse; also given though Well Child and nurse; also given though Well Child and OB clinics; immunization compliance OB clinics; immunization compliance assessed during well child conferences, assessed during well child conferences, well baby home visits, and by school well baby home visits, and by school nursesnurses

• 1970’s Galveston Health Department 1970’s Galveston Health Department became part of GCHD; immunizations still became part of GCHD; immunizations still only 2 half-days per week; CHN’s helped only 2 half-days per week; CHN’s helped with back-to-school rush; clerk sent out with back-to-school rush; clerk sent out immunization remindersimmunization reminders

History (cont)History (cont)• 1980’s Immunization Nurse funded; 1980’s Immunization Nurse funded;

CHN’s worked closely with day care CHN’s worked closely with day care centers and schools; no formal tracking centers and schools; no formal tracking program; Immunizations were provided program; Immunizations were provided on the island, mainland, and in on the island, mainland, and in outreach locations in the North countyoutreach locations in the North county

• 1990’s Clerk hired; TVFC program 1990’s Clerk hired; TVFC program started in 1994; ICES and CASA started in 1994; ICES and CASA systems initiated; first CASA report systems initiated; first CASA report showed Galveston at 43% (children 2 showed Galveston at 43% (children 2 and under) and under)

History (cont)History (cont)

• 2000 to present ICES updated to TWICES 2000 to present ICES updated to TWICES (web-based electronic immunization records); (web-based electronic immunization records); GCHD was one of the first to pilot PICS (TDH GCHD was one of the first to pilot PICS (TDH pharmacy inventory)pharmacy inventory)

• Currently Currently – 3 satellite clinics open a total of 80 hours per week 3 satellite clinics open a total of 80 hours per week – 8 FTE’s (Immunization nurses and clerks)8 FTE’s (Immunization nurses and clerks)– 42 VFC providers (GCHD responsible for training, 42 VFC providers (GCHD responsible for training,

monitoring, follow-up site visits) monitoring, follow-up site visits) – ~ $ 375,000 budget (with ~ $85,000 reimbursed) ~ $ 375,000 budget (with ~ $85,000 reimbursed)

TDHTDHVision and MissionVision and Mission

VisionVision

Eradicate vaccine Eradicate vaccine preventable preventable

diseases from diseases from Galveston Galveston

county county

MissionMission

To immunize all children in To immunize all children in Galveston county by age Galveston county by age two in accordance with two in accordance with

the current Texas the current Texas Department of Health Department of Health recommendations. recommendations.

PRIORITY #8: PREVENTION BY MMUNIZATION

Immunize Children and Adults

to Prevent Infectious Diseases.

Strategic Health Plan GoalsStrategic Health Plan Goals

• Goal 1: Designate leadership and Goal 1: Designate leadership and establish local plans and goalsestablish local plans and goals

• Goal 2: Improve availability and accuracy Goal 2: Improve availability and accuracy of local data to enhance tracking, of local data to enhance tracking, assessment, and feedbackassessment, and feedback

• Goal 3: Identify and reduce barriers to Goal 3: Identify and reduce barriers to immunizationsimmunizations

• Goal 4: Increase education and awareness Goal 4: Increase education and awareness among all responsible groupsamong all responsible groups

• Goal 5: Define, align, coordinate, and Goal 5: Define, align, coordinate, and seek resourcesseek resources

Goal 1: Designate leadership Goal 1: Designate leadership and establish local plans and and establish local plans and

goalsgoals

• Objective One:Objective One: Establish the Establish the Galveston County Health District as Galveston County Health District as the lead organization for local the lead organization for local planning to improve immunization planning to improve immunization rates using the medical home model in rates using the medical home model in Galveston County.Galveston County.– Galveston County Immunization Advisory Galveston County Immunization Advisory

Council was established and had first Council was established and had first meeting on 7/8/04meeting on 7/8/04

Goal 2: Improve availability and accuracy of Goal 2: Improve availability and accuracy of local data to enhance tracking, assessment, local data to enhance tracking, assessment, and feedbackand feedback

• Increase number of Vaccines for Children Increase number of Vaccines for Children (VFC) providers(VFC) providers– 2003: 35 VFC providers2003: 35 VFC providers– Currently: 42 providersCurrently: 42 providers

• Retrospective kindergarten studiesRetrospective kindergarten studies– 2003 study (2/04) assessed immunization 2003 study (2/04) assessed immunization

status of children who would have been 2 status of children who would have been 2 years old in 1999- 2000; 60.7% adequately years old in 1999- 2000; 60.7% adequately immunized (4-3-1-3-3) by age 2 and 87.4% by immunized (4-3-1-3-3) by age 2 and 87.4% by age 5. National goal is 80%.age 5. National goal is 80%.

Goal 2: Improve availability and accuracy of Goal 2: Improve availability and accuracy of local data to enhance tracking, assessment, local data to enhance tracking, assessment, and feedback (cont)and feedback (cont)

• Day care studiesDay care studies– 2003 study (completed January 2004)2003 study (completed January 2004)

•155 childcare facilities155 childcare facilities•5304 records5304 records• Initial visit 82.4% “up-to-date” (in Initial visit 82.4% “up-to-date” (in

compliance with TDH Minimum State compliance with TDH Minimum State Vaccine Requirements for Texas Children)Vaccine Requirements for Texas Children)

•30- day follow-up visit: 99.3% up-to-date 30- day follow-up visit: 99.3% up-to-date

– Reports available at www.gchd.orgReports available at www.gchd.org

Goal 4: Increase education and Goal 4: Increase education and awareness among all responsible awareness among all responsible groupsgroups

• Education efforts January- June 2004:Education efforts January- June 2004:– Presented or hosted 5 educational activities with Presented or hosted 5 educational activities with

a total of 80 participantsa total of 80 participants– Participated in at least 2 health fairs and the Participated in at least 2 health fairs and the

Teen Health Round-upTeen Health Round-up– Answered 1,387 phone calls related to Answered 1,387 phone calls related to

vaccination from school nurses, medical offices, vaccination from school nurses, medical offices, and the publicand the public

– Participated in educational activities related to Participated in educational activities related to bioterrorism/ emergency management (mass bioterrorism/ emergency management (mass vaccination clinics, Strategic National Stockpile, vaccination clinics, Strategic National Stockpile, mass antibiotic administration)mass antibiotic administration)

Annual ActivitiesAnnual Activities

• National Infant Immunization Week National Infant Immunization Week ActivitiesActivities

• Kid’s Fest- Back-to-School Kid’s Fest- Back-to-School Immunization ClinicsImmunization Clinics

• Senior Health Fests with “Flu Shot” Senior Health Fests with “Flu Shot” activitiesactivities

National Infant Immunization National Infant Immunization WeekWeek

• April 26- May 1, 2004April 26- May 1, 2004

– Regular immunization clinics + 1 outreach Regular immunization clinics + 1 outreach clinic per day- locations determined by clinic per day- locations determined by “pockets of need” (19 immunization “pockets of need” (19 immunization sessions)sessions)

– 281 people immunized281 people immunized– 786 immunizations given786 immunizations given– 39 volunteers39 volunteers– 4,000 fliers distributed4,000 fliers distributed

Kid’s Fests- Kid’s Fests- Back-to-School ImmunizationsBack-to-School Immunizations

Kid’s Fests- Kid’s Fests- Back-to-School ImmunizationsBack-to-School Immunizations

• Texas City and Dickinson Texas City and Dickinson Immunization Clinics relocated to La Immunization Clinics relocated to La Marque office July 26- August 17Marque office July 26- August 17

• Galveston Clinics remain the sameGalveston Clinics remain the same

• 2003: 3,212 immunizations given at 2003: 3,212 immunizations given at La Marque Clinic; 4,692 La Marque Clinic; 4,692 immunizations total in August 2004immunizations total in August 2004

Senior Health FestsSenior Health Fests

October 2003 activities:October 2003 activities:

– 6 locations6 locations– 461 immunizations given461 immunizations given– Other activities included B/P Other activities included B/P

checks, diabetes screenings, checks, diabetes screenings, exercise demonstration, exercise demonstration, assistance with QMB assistance with QMB

““Thinking Progressively for Thinking Progressively for Health” AwardHealth” Award

• Presented to GCHD staff at Texas Public Health Presented to GCHD staff at Texas Public Health Association meeting April 18- 20, 2004Association meeting April 18- 20, 2004

• For aggressive strategies being taken in For aggressive strategies being taken in Galveston County to improve immunization rates Galveston County to improve immunization rates with innovative outreach techniques implemented with innovative outreach techniques implemented by the District such as the "medical home model" by the District such as the "medical home model" of immunization delivery which promotes the of immunization delivery which promotes the delivery of immunizations within ones medical delivery of immunizations within ones medical home and encourages clinical preventative home and encourages clinical preventative healthcare healthcare

2004 TDH Immunization 2004 TDH Immunization AuditAudit

July 2004July 2004

  4-3-1 * 4-3-1-3-3 ** Drop-out rate: DtaP

Drop-out rate:

Hep B

Missed opportuniti

es

LaMarque 80% 80% 13% 7% 0%

Galveston 81% 81% 16% 3% 0%

Dickinson 70% 68% 23% 9% 2%

Texas City 75% 75% 20% 5% 0%

Immunization StaffImmunization Staff