Faculty Bibliography

Immunization (IZ) information systems (IISs) are confidential, computerized, population-based systems that collect and consolidate IZ data from vaccination providers. The American Academy of Pediatrics continues to support the development and implementation of IISs as a beneficial tool to provide quality health care for children. Since the last revision of the American Academy of Pediatrics policy statement on IISs in 2006, numerous public health events and new data demonstrate the importance and value of these systems in society and expand the functionality and benefits of IISs beyond the basic IZ database intended to improve childhood IZ rates. This policy statement update will describe additional functions and benefits of IISs, as well as persistent and novel challenges and barriers that these systems face and pose to practicing pediatricians. Pediatricians and other pediatric health care practitioners should be aware of the value of IISs to society, the incentives and barriers involved in incorporating IIS access into a medical practice, and the opportunities to improve IISs and their functionality and usability in daily pediatric practice.

BACKGROUND: Health care workers (HCWs) can acquire and transmit influenza to their patients and coworkers, even while asymptomatic. The U.S. Healthy People 2010 initiative set a national goal of 60% coverage for HCW influenza vaccination by 2010. Yet vaccination rates remain low. In the 2008-2009 influenza season, Flushing Hospital Medical Center (FHMC; New York) adopted a "push/pull" point-of-dispensing (POD) vaccination model that was derived from emergency preparedness planning for mass vaccination and/or prophylaxis to respond to an infectious disease outbreak, whether occurring naturally or due to bioterrorism. LAUNCH OF THE HCW VACCINATION PROGRAM: In mid-September 2008, a two-week HCW vaccination program was launched using a sequential POD approach. In Push POD, teams assigned to specific patient units educated all HCWs about influenza vaccination and offered on-site vaccination; vaccinated HCWs received a 2009 identification (ID) validation sticker. In Pull POD, HCWs could enter the hospital only through one entrance; all other employee entrances were "locked down." A 2009 ID validation sticker was required for entry and to punch in for duty. Employees without the new validation sticker were directed to a nearby vaccination team. After the Push/Pull POD was completed, the employee vaccination drive at FHMC was continued for the remainder of the influenza season by the Employee Health Service. RESULTS: Using this model, in two days 72% of the employees were reached, with 54% of those reached accepting vaccination. CONCLUSIONS: This model provides a novel approach for institutions to improve their HCW influenza vaccination rates within a limited period through exercising emergency preparedness plans for infectious disease outbreaks.

To achieve high immunization levels among populations indicated to receive hepatitis A and/or B vaccine, strategies must be implemented to integrate vaccination into routine medical care. Such strategies must address the educational needs and communication skills of providers, patients' awareness of the diseases and the vaccines, the complexity of existing office systems, documentation issues including the use of immunization registries, reimbursement and third-party coverage issues, and ongoing office-based quality assurance. This article describes office-based approaches to implementing hepatitis vaccination programs and some of the tools available to facilitate this process.