Increasing Maternal Influenza and Tdap Vaccination Helen Medlin BSN - - PowerPoint PPT Presentation

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Increasing Maternal Influenza and Tdap Vaccination Helen Medlin BSN RN Florida Department of Health Brevard County Objectives: Review the Advisory Committee on Immunization Practices (ACIP) recommendations for maternal influenza and Tdap

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Increasing Maternal Influenza and Tdap Vaccination

Helen Medlin BSN RN Florida Department of Health Brevard County

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Objectives:

  • Review the Advisory Committee on Immunization Practices

(ACIP) recommendations for maternal influenza and Tdap vaccines.

  • DOH Brevard Quality Improvement proj ects aimed at increasing

the Influenza and Tdap vaccinat ion in the maternal population

  • f Brevard County.
  • Premise on which we based our actions.
  • Actions taken to improve vaccination rates.
  • Results and conclusions.

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ACIP Influenza Recommendations:

Influenza Vaccine:

  • Recommended for pregnant women at any point in the

pregnancy.

  • When the vaccine is first available.
  • If pregnant in two influenza seasons to receive both seasonal

influenza vaccines.

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ACIP Tdap Recommendations

Tdap Vaccine:

  • 2011 booster in pregnancy if no adult booster received.
  • 2012 every pregnancy between 27-36 weeks irrespective of the

prior history.

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Quality Improvement Projects

  • 2013-2014 Increasing Influenza Vaccinat ion in the Maternal

Population of Brevard County.

  • 2015 Increasing Influenza and Tdap vaccinat ion in the Maternal

Population of Brevard County.

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Where w e started

  • 2012-2013 we gave 15 doses of Influenza vaccine to our

maternity clients.

  • 2014 we gave 75 doses of Tdap to our maternity clients.
  • Did not have numbers for the private practices.

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Premise

S tudies consistently show that clients are more likely to receive vaccines if their primary care provider recommends the vaccines and there is easy access to vaccination. (CDC)

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Approaches

  • Beliefs and practices
  • Education
  • Partnering with community providers
  • Vaccine accessibility
  • Improvement of documentation
  • Education resources.

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Beliefs and Practices

  • S

taff survey 2013-2014

  • Follow up survey 2014-2015.
  • Addressed barriers to immunization in staff.
  • Provided education.
  • Promotion of influenza vaccine at beginning of season.
  • Offered staff vaccinat ion at meetings and through the clinics.
  • Monitor success in increasing staff vaccinat ion rates.

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people who can't be vaccinated

ERADICATING AN INFECTIOUS DISEASE CAN ONLY HAPPEN IF EVERYONE IS PROTECTED FROM IT

l'FS

MEDICINEWISE

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Education

Increase understanding of influenza and Tdap vaccines:

  • S

afety and efficacy.

  • Influenza disease and its effects on pregnant women and

unborn child.

  • Concept of cocooning.

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Partner w ith Community Providers

S urveyed local OBGYN doctors representing each practice regarding vaccinat ion recommendation, barriers and challengers:

  • Vaccines recommended but not offered at practice.
  • Limited knowledge of places to refer clients for vaccines.
  • Cost of vaccinat ion, lack of insurance coverage.
  • Clients fears, misinformat ion, inconvenience.

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Partner w ith Community Providers

  • Have all private providers recommended influenza and Tdap

vaccines to clients.

  • Utilize DOH Brevard Immunization nurse as a resource for

vaccine hesitant clients.

  • Accessibility of vaccines through the DOH Brevard clinic sites.

Created a flyer for private practices.

  • Created a resource: community providers and pharmacist s who

vaccinate pregnant women.

  • Partnered with Healthy S

tart for early education of pregnant women.

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Vaccine Accessibility

  • DOH maternity clients offered vaccines during perinatal visit.
  • Three clinic sites offer vaccine to pregnant women and their

families on a walk in basis, no appointment necessary.

  • Free Tdap for underinsured through program 17.
  • Addition of program 17 influenza.

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Improvement of Documentation

  • Immunization Policy and Procedure changed to reflect practice
  • f immunizing pregnant women.
  • DOH Brevard IPO was updated to include the practice of
  • ffering vaccines to maternity clients.
  • Developed clear documentation of vaccinat ion offered,

declined accepted,

  • Document vaccinat ion in Florida S

hots.

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Education Resources

Prenatal package contains information about the Tdap and Influenza vaccines in pregnancy. Created DOH Brevard brochures for “ Pregnancy and Influenza” and “ Pregnancy and Tdap Vaccine” CDC flyers distributed to all DOH clinics and private OBGYN practices.

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Where can I go for more Information?

Pregnancy andWhoopingCough

www.cdc.gov/pertussis/ pregnant

Im munizations for Women

www.immunizationforwome11.mg/ immunization_facts/vaccine- p.reventaMe_diseases/ pertussis

Vaoo'nes during Pregnancy

  • www. mic:iwiife.orglomot-vacci11es-duni ng-

preg11ancy AmericanAcademy of family !

Physicians

www.aafp.org/patient-care/immunizations/ disease-popul lation.MmI I

Tdap \laodi ne l

lnformatlon Statement (VIS):

www .cc:ic.gov/vaoc,i 11es/ ltmp/ vis/ vis- statements/ tdap.lltmI

Ask your provider about getting the Tdap Vaccine during your third trimester

Pregnancy and The Tdap Vaccine

FLORIDA DEPAR

T MENT O F

HEA LTH IN BREVARD COUNTY

Mlulon

To protect, promote. and Improve the health of all people in Fl-orlda,through integrnted state, county and community efforts.

Vision

To be the l'lealthlest state in the nation.

YIIues; (IOARE)

Innovation: We search for creative solutJions and manage resources wisely. . Collaboration: We use teamwork to achieve common goals & s-olve•problems. Accountability: We•perform with integrity andi respect. Responsiveness: We achieve our mission by serving our customers & engaging our partners.

  • Excellence. We promote qua.lity outcomes

through learning & continuous performance improv ment.

HID-240E (09-15)

F l

  • rida Oe1>1rtmen

t of

Health in,Brevard County

2575 N. Courtney ~ rnway Merritt Island, FL 32953 321-637-7300 www.floridahealth.gov

B evard County

FLORIDA DEPARTMENT OF HEALTH IN BREVARD COUNTY

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DON'

G VE

FACTS

TDAP S THE BEST

PERTUSS S TO

+ Pertussis (wl

hooping cough) is

PROTECT ON FOR

YOUR BABY-

GET VACCINATED

Pertussis symptoms include:

+ Nasal

l congestion

+ Fever + Sneezing

  • Milld cou gh

+ The cough can progress into

an intense cough that can last for several m·nutes. a respiratory tract infection.

+ Pertussis is s1

imi l ! ar to a common col ld except tl he cough progresses into an intense cough t: hat can l last for several ! minutes.

+ Pertussis can be a deadly

infection to NEWBORNS.

+ Sinee 2010 approximatelly 10

to 20 babies have d·ed per year due to Pert ussis.

+ Newborns do not receive their

fi rst vacci nati ions until l they are two months olld.

+ Mothers can prov1ide immun1

ity to her ch ild by receiving the Tdap vaccinat ion when she is 27 to 36 weeks pregnant.

YOUR BABY

The Tdap Vaccine

  • Tdap is an injection.
  • Tdap is recommend for

pregnant women between 27- 36 weeks.

  • Research has sl

hown it is safe during pregnancy.

  • Women can still breastfeed

after vaccinat ion.

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Monitoring Success and Failures

  • Measuring impact on private providers and their clients was

difficult.

  • Utilized the HMS

system to monitor the impact on DOH Brevard perinatal clients and DOH Brevard S taff.

  • Audited client files to assess success in increasing the clients
  • ffered vaccinat ion.

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Influenza Dose.

s Adm·nistered to Maternity Clients

243

164 66

.. ··.

  • ·.

15

12-13 13-14

14-15,

15-· 16

16-17

17-18

INFLUENZA SEASON

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Tdap Dos, es A, dmin1 ste1 red to I

Mate11nity C lients %, Maternity Clients

460

408

59%

275

33%

75

2014

2CJi15

2017

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BREVARD CO NTY PERT SSIS CASES INC ILDREN N E · 1 YEA · 0 AGE.

4

. 3

2 2

1

2010 2011 2012 2013

2014 2015 .2016 .2017

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Conclusion

Continue to increase our rates of maternity clients in Brevard County:

  • Education of staff.
  • Improving the culture of vaccination.
  • Easy access to vaccines.
  • Removal of cost barrier with program 17 vaccines.

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References

  • The American College of Obstetricians and Gynecologists: ACOG

Committee Opinion Number 608-S eptember 2014.

  • The American College of Obstetricians and Gynecologists: ACOG

Committee Opinion Number 718-S eptember 2017.

  • https:/ / www.cdc.gov/ vaccines/ pregnancy/ pregnant-

women/ index.html

  • http:/ / www.immunize.org/
  • https:/ / www.cdc.gov/ vaccines/ pregnancy/ hcp-

toolkit/ resources.html

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References.

https:/ / www.cdc.gov/ flu/ fluvaxview/ pregnant- coverage_1516estimates.htm. Morbidity and Mortality Weekly Report (MMWR) Tdap Vaccination Coverage During Pregnancy-S elected S ites, United S tates 2006-2015, October 20,2017/ 66(41);1105-1108.

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Questions.

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