International visitors at WithinReach
- An Immunity Community parent advocate meeting in Bellingham
- An opportunity to learn from our colleagues about vaccine hesitancy research projects at the Group Health Research Institute
- A visit to the Washington State Department of Health
- A major event at PATH highlighting the resonances between the vaccine hesitancy work happening locally and globally
- A tour of the school-based health center at Nathan Hale High School
- A learning opportunity at, and tour of, Seattle Children’s Hospital
We’ve learned so much already. South Africa faces many challenges that parallel what we see in the United States, specifically focused on trust in the health system and the impact of cultural norms on vaccination. I think we all feel a sense of awe about the challenges faced in Afghanistan, where hesitancy often emerges from violent propaganda and edicts of rogue groups like the Taliban, which threaten the lives and livelihoods of immunizers at times. Nonetheless, our conversations have focused on new and creative strategies, like activating social networks, creating projects focused on specific ethnic groups, engaging performance opportunities like songs, etc. in addressing vaccine hesitancy.
Many thanks to all of the people who have come together to make this week a success!
Top Ten Ways to Be A Positive Voice For Vaccines!
3. Get up to date on your own vaccines. Check if you are up to date in MyIR. Haven’t used MyIR yet? Sign up by visiting the Washington State Department of Health’s website and choose Option 1. Once you are in the system, you can print off your recommended immunizations and bring them to your healthcare provider or pharmacist. While you’re at it, check to make sure your kids and your family members are up to date as well.
4. Share your immunization story. Why are you passionate about vaccines? Whether you’ve personally experienced a vaccine preventable disease, or someone you love has been impacted, sharing your story with us to use on our website and social media is a powerful way to be an advocate. Contact us at email@example.com.
6. Advocate for immunizations to friends and family. Vaccines aren’t a “taboo” topic – they’re an important part of preventive health. Have the courage to ask family members if they’re up to date on their vaccines, if they got their annual flu vaccine, or if they’re planning to immunize their newborn. And remember, most people fully vaccinate on time. Here’s a great article on how to approach the subject using the HEART method for talking about immunization with friends.
7. Become a member of the Immunization Action Coalition of Washington (IACW). The IACW meets quarterly to learn about and collaborate on a variety of immunization topics. Recent topics have included: HPV prevention, vaccine hesitancy, and global health initiatives. Additionally, there is a monthly newsletter with hot topics, resources, and news articles to keep you up-to-date! To learn more and become a member, email: firstname.lastname@example.org.
8. Take action. Your help in promoting vaccines in Washington State will help keep our community healthy and decrease the transmission of vaccine-preventable diseases. Sign up for our Immunization Action Alert to be notified when you can lend your voice to advocating for immunizations in Washington.
9. Write a letter to the editor. Let your pro-vaccine stance be known to your community and elected officials. Contact us if you need help with any ideas or templates.
10. Thank an Immunizer. Next time you are at your healthcare provider’s office or the pharmacy, thank an immunizer. These are the people that protect health by vaccinating, and people often forget to thank someone holding a needle!
Immunization Program: 2015 Reflections & 2016 Opportunities
- We welcomed Jessica Broz, Immunization Coordinator, to our team. Jessica has been a wonderful addition, supporting all of the work we do with skill and a thoughtful approach.
- The Pink Book Conference, which the Immunization Team hosted in September, was a sold-out event that brought together 450+ colleagues from around the state to learn, network, and strengthen relationships.
- The Immunity Community, our program that engages parents as immunization-positive advocates in the spaces where their children spend time, expanded into a truly statewide program, with active communities in Spokane, Thurston, Snohomish, Kitsap, and Whatcom Counties.
- We developed an HPV educational webinar for healthcare providers. This webinar shares the latest communication science around vaccines and encourages a strong HPV vaccine recommendation and has been taken by over 700 healthcare providers.
- WithinReach began hosting the HPV Task Force, a collective of partners statewide that are convening to collaborate on promoting HPV vaccine uptake and series completion.
And in 2016, we look forward to:
- The continued expansion of the Immunity Community.
- Re-energizing the Vax Northwest work with healthcare providers, hopefully developing a new research project focused on provider-parent communication.
- Learning more about what drives parent decision-making about vaccines in Washington State, and where we might best intervene through focus groups across the state.
- Extending the stellar work of our Spokane Regional Health District partners to provide mobile immunization clinics and other tools to improve immunization record-keeping statewide.
- Restructuring the Immunization Action Coalition of Washington’s committees to better align with needs in the state.
- Connecting with current and new partners to promote HPV vaccine uptake.
To the exceptional Immunization Team at WithinReach, thank you for being so proactive and skilled in producing work of an outstanding caliber. To all of our partners with whom we collaborate on these successes, thank you for your great work independently and with us!
Wishing everyone a healthy and happy New Year!
Tis’ the Season!
“Never doubt that a small group of thoughtful and committed citizens can change the world; indeed, it’s the only thing that ever has.” This quote by the late cultural anthropologist Margaret Mead is truly apropos to a recent partnership that WithinReach and many others have been involved in!
Less than a month ago, one of our Community Partnership Associates at WithinReach, Jefferson Rose, was contacted by Ellie Marsh, President of the Western Washington Chapter of the National Association of Hispanic Nurses (WW-NAHN), about a school in the Edmonds School District that had several dozen children that were either unvaccinated or under-vaccinated due to lack of access to a medical home. These children needed a number of required vaccinations by January 4th in order to continue attending school.
Jefferson passed along this information to the Immunization and Healthy Connections Teams at WithinReach, which quickly mobilized to see what we could do to get these children vaccinated and connected to health insurance. Through our relationship with the Snohomish Health District we connected the health department and WW-NAHN together, and this is where the magic truly happened!
I’m excited to report that the WW-NAHN, in conjunction with Spruce Elementary School, WithinReach, Snohomish Health District, and the University of Washington School Of Nursing, hosted an immunization clinic for these families on Wednesday, December 16, 2015.
All vaccines were provided for free by the Snohomish Health District, six nursing students from the UW were on hand to give all of the injections to children, and WithinReach’s multi-lingual in-person assisters – Maricruz and Irina — were on hand to sign families up for health insurance, and provide other community resources for families!
As a result of all of these efforts, we learned that nearly half of the students that were previously identified as out of compliance with their immunizations were able to show proof of the required immunizations, and the other half received all the vaccinations necessary to stay in school.
Thank you to all the amazing partners who rallied together to protect kids from vaccine-preventable diseases and get them signed up for health insurance.
Tags: community resources immunizations Partnership School Snohomish Health District Spruce Elementary School University of Washington School Of Nursing vaccines Western Washington Chapter of the National Association of Hispanic Nurses WW-NAHN
Good Neighbors: Why We Love School Nurses
School nurses may also put a lot of time into following up with parents who haven’t provided either immunization records or an exemption form. For families who are struggling to find healthcare for their children, they connect them to local resources including immunization clinics so that students can get the care they need. They answer parents’ questions about immunizations and the school requirements. And even once they have all the documents in order, the nurses must enter the data and report it to the Washington State Department of Health. And finally, they must keep all those records organized so that unimmunized students can be quickly identified in the event of an outbreak. When next fall rolls around, they do it all over again. Whew!
With a little funding, we can improve the technology that school nurses use to gather and report immunization information, making the process more efficient and accurate for everyone involved. With many school nurses responsible for multiple schools and thousands of children, there’s no time for redundant data entry. At WithinReach, we are grateful for the dedication and hard work that school nurses across Washington put into protecting our children’s health. Let’s support our school nurses by putting the best tools we can into their hands, so they can do their best work keeping kids safe, healthy, and learning.
It’s time to give the flu vaccine the respect it deserves
Recently, I was talking with my pro-vaccine friends who became parents not too long ago. They have an eight-month old baby and are following the CDC’s recommended childhood vaccination schedule. They consider themselves to be strong vaccine supporters and trust in the science of vaccination and the protection vaccines provide. You can find Facebook posts of their baby immediately following her vaccine doses. In the pictures she’s smiling with captions like: “I got fully vaccinated and this is how happy I am about it only 3 minutes later.” However, when I brought up the flu shot they were quick to dismiss it.
Why is the flu vaccine viewed differently from other vaccines?
If I’m perfectly honest, there was a time when I too thought of the flu vaccine as somehow inferior and less important than the other vaccines. Data shows that I am not alone. Even though the flu vaccine is nearly universally recommended for individuals over 6 months old, it has one of the lowest coverage rates when compared to other vaccines. Last year, less than half of those eligible received the vaccine. People often opt out of the flu vaccine due to some key misunderstandings, but below are the compelling facts for consideration.
Here are the facts about flu strains.
Unlike other viruses, the flu is constantly changing. Each year influenza experts predict which strains of the virus will be most common and develop a vaccine to protect against those strains. Some years these predictions are better than others. The good news is that even when the vaccine does not match with the circulating viruses as perfectly as we hope, some protection is still better than no protection. And more good news: early tests indicate that this year’s vaccine is a better match than last, which will make it more effective against preventing the flu.
The flu vaccine cannot cause the flu.
The vaccine is comprised of either dead or weakened virus strains (depending on which vaccine you receive) making your likelihood of contracting the flu from the vaccine impossible. The flu vaccine takes up to 2 weeks to provide protection, so get your shot early to maximize its benefit.
The flu can be miserable and dangerous even for healthy people.
I used to think I was tougher than the flu. My immune system is strong – I can handle the flu. Let’s assume I’m right and that I survive two weeks of muscle aches, chills, sweats, fevers and vomiting caused by the flu. Many aren’t so lucky and by hosting the flu virus, I could pass it to others when I’m infected but have no symptoms. The flu is most dangerous for those 65 and over and infants under two, as well as people with common health conditions such as asthma, diabetes, and even pregnant women. Each year, thousands of hospitalizations and deaths are a result of the flu. By getting the vaccine, I not only protect myself from the dreadful symptoms but I also protect those around me who may be at a higher risk of suffering serious complications.
So get out there and get your flu shot! I may not have been able to persuade my friends but I’ll keep presenting them with the facts. The flu vaccine is available at pharmacies and doctor’s offices. I got mine and feel happy about not only protecting myself but relieved to be protecting vulnerable individuals in my community.
Promoting a healthy Washington: the Pink Book Course
Growing the Immunity Community
WithinReach is excited to announce that the Immunity Community (IC) is growing! We are thrilled to expand the IC into Snohomish, Kitsap and Thurston Counties for the 2015 – 2016 school year thanks to generous support from the Group Health Foundation. We will continue our work in Bellingham and Spokane, building on the successful partnerships established over the last few years. A program of Vax Northwest, the IC is a proven community engagement campaign where parents who value immunization confidently speak in support of immunization in their communities. The program seeks to reduce vaccine hesitancy by mobilizing parents to have positive conversations about immunizations with other parents through a variety of activities, reinforcing vaccination as a social norm.
Immunity Community Parent Advocates (PAs) are volunteers connected to sites such as elementary schools, childcare centers, and preschools. Each fall a “Launch Meeting” kicks off the beginning of the IC program; PAs are trained to talk about vaccines, and brainstorm pro-vaccine actions they can take in their communities. Local health department staff also participate by presenting on current vaccine topics. Support continues throughout the school year with PAs receiving ongoing technical assistance, including monthly newsletters, flyers, postcards, shareable social media images and giveaways for events, among many other resources. PAs use multiple strategies to raise awareness and educate parents at their sites and in their communities, including social media advocacy, hosting events, distributing immunization-related materials, engaging in one-on-one conversations, and working to calculate and publicize site immunization rates. PAs share their stories about deciding to vaccinate their children and tailor their immunization advocacy to what works best for them and their communities.
Rigorous evaluation by the Group Health Research Institute’s Center for Community Health and Evaluation has shown this parent-to-parent campaign to be successful. Specifically, the IC has:
- Trained parent volunteers to be effective immunization advocates in their communities
- Raised awareness of vaccine-related issues in the focus area communities
- Increased support for vaccination among parents surveyed in focus area communities
- Facilitated a preschool policy change that has statewide impact
We are excited to continue the IC in Bellingham and Spokane and expand into Snohomish, Kitsap and Thurston Counties this fall because of the support from Group Health Foundation. The IC is part of a multi-faceted approach to health that WithinReach undertakes with its partners to promote a healthy Washington, and we look forward to continuing this outstanding body of work.
Fighting health inequities, one shot at a time
Did you know that Latina women in the US are over 1.5 times more likely to be diagnosed with cervical cancer than non-Latinas and, once diagnosed, 1.5 times more likely to die from cervical cancer? To us at WithinReach, inequities like this are unacceptable.
Some of the factors that contribute to this inequity include lack of access to quality care, making Latinas less likely to get regular Pap smears, more likely to have more advanced cervical disease when they are screened, and less likely to receive follow-up care after diagnosis. Without a doubt, Latinas need better access to care and better quality of care when they do have access. But to get to one root of the problem, we need to prevent cervical cancer in the first place. Fortunately, we have a very effective way to do so: the HPV vaccine.
That’s why it’s disturbing to us that Latino parents are less likely to report that their provider recommended the HPV vaccine for their child(ren). Among a group of Latino parents in Yakima, 87% said that they would get their daughter vaccinated if their doctor recommended it, but only 46% had actually ever been offered the HPV vaccine!
We’re working to change that through a project offering targeted training to providers and staff in clinics that serve Latino families in western Washington. We talk about why the HPV vaccine is so important, how to make an effective recommendation, and how to have respectful and helpful conversations with parents about it. Luckily, we found a great partner for this work in the Seattle Cancer Care Alliance.
Inspired by its Community Health Needs Assessment (CHNA), Seattle Cancer Care Alliance (SCCA) launched a Community Health Improvement Grant program to addresses specific cancer screening, early detection, and prevention needs for at risk populations in King, Snohomish, and Pierce counties. Designed to build sustainable collaborations with Washington communities, SCCA selected seven local nonprofit organizations to receive funds in 2015, including WithinReach.
Finally, I can’t end this post without mentioning that the HPV vaccine prevents many different cancers that are caused by the human papillomavirus in both men and women, including cancers of the anus, oropharynx (throat area), and genitals. No one wants those diseases for their children. That’s why it’s important for both boys and girls to be immunized! And for providers out there interested in the latest on HPV immunization recommendations and how to navigate conversations with families, check out our free online CEU course.
Protecting newborns from whooping cough: a new protocol at WithinReach
A few weeks ago, WithinReach’s Immunization and Healthy Connections Teams collaborated to roll out a new conversation pathway with callers to the Family Health Hotline, where our friendly and informed staff helps callers understand and apply for a variety of food, health, and child development resources in Washington State. We are proud of the fact that all pregnant callers, or all callers who are in a household with a pregnant person, are now being advised of the recommendation that all pregnant women get a booster of the Tdap vaccine in every pregnancy. The Tdap booster ensures continued immunity from three diseases: tetanus diphtheria, and pertussis. We are particularly concerned about pertussis, commonly known as whooping cough, in Washington for several reasons:
- We are seeing a surge in new cases right now.
- Whooping cough makes babies very, very sick, and some die.
- Most babies who get whooping cough get it from a person in their household, particularly a parent.
- If the booster is given to the mother in the third trimester, some immunity will be conferred to the baby, offering some protection if the baby is exposed to an infected person.
- Babies cannot begin the vaccination series until they are 8 weeks old.
The above-listed reasons, combined with the fact that our Healthy Connections Team interfaces with more than 250,000 families per year, makes this the ideal venue to protect families from this disease. This recommendation is new, so many people may not have heard about it. To learn about the recommendations for pregnant women, read more from the Centers for Disease Control and Prevention.
Lastly, antibodies for pertussis wane over time, so it’s critical that everyone (regardless of if you are in contact with a pregnant woman) consult their doctor about a booster. In particular, adolescents are scheduled to get their booster dose of Tdap in the 11-12 age range. But outside of these groups, please make sure you’re up-to-date with your Tdap vaccine, especially if you did not get a booster as a teen or pre-teen. With waning immunity, risk increases, and the best thing you can do to protect a newborn is to ensure that you’re providing a disease-free cocoon around that child.
Creating a Healthy Washington: The Pink Book Training
I have a strong belief that anyone who works in the field of public health is an everyday hero. These professionals work “behind the scenes” to keep us all safe and healthy every day, but their work largely goes unnoticed if they’re doing their jobs well. Immunization falls into this category; by getting kids immunized on-time, diseases that used to plague our community have nearly vanished.
But the job isn’t easy and it requires tremendous technical expertise. Vaccines need to be stored, timed, and dosed appropriately, and providers need to know of contraindications, among myriad other factors. It’s important that we consistently provide immunization champions and providers with the opportunity to stay abreast of immunization best practices as well as the science of vaccines, which includes the fields of immunology and virology.
This is why WithinReach is thrilled to be hosting The Epidemiology and Prevention of Vaccine-Preventable Diseases Course, colloquially known as The Pink Book Course (because of the pink book that contains all of the information from the course) September 15-17, 2015 at the Hotel Murano in Tacoma, WA. We are proud to offer this opportunity to health care providers in Washington State and beyond. Faculty from the Centers for Disease Control’s National Center for Immunization and Respiratory Diseases will present a live, two-day comprehensive review of immunization principles, as well as vaccine-preventable diseases and the recommended vaccines to prevent them. We’ve planned some great pre-course workshops as well, on topics from vaccine hesitancy to using our state’s immunization registry.
Perhaps most importantly, the course will bring together our colleagues, giving them the chance to learn and network. The course also offers 14 continuing education credits for just $250, making it an exceptional value. To learn more about the course, or to register, please visit the course website. Opportunities for comprehensive, inexpensive, and immunization-specific education are rare; we’re happy that we can organize this opportunity for our peers and we encourage you to spread the word. Reserve early to save your seat!
Vaccine Education Across Language and Culture
By Judith Pierce, WithinReach Immunizations Graduate Intern.
From April 18-25, we’re celebrating National Infant Immunization Week. Did you know that routine childhood immunization in one birth cohort prevents about 20 million cases of disease and about 42,000 deaths? It’s pretty awesome. That’s why we work to ensure that all children in Washington have access to immunizations, and their parents have the information they need to make a good decision. Unfortunately, not everyone has the same access to health information. Below, our graduate intern, Judith Pierce, describes her work with us to help address one of these gaps.
In summer of 2014 I had just completed my first year of public health school, and was in search of a year- long project for my capstone requirement. I knew I wanted to practice skills in evaluation and data analysis, but I also wanted a project with content that would be able to hold my interest for a year. When I initially approached WithinReach’s Immunization program, I was really interested in their work with provider training and the Immunity Community, and assumed I would work on those projects. Instead, they gave me the opportunity to develop a community forum for Russian speakers. Through speaking with the Immunization team I learned that Russian speakers have the lowest childhood immunization rates of any population in Washington, and have had the lowest rates since 2008. This was incredibly interesting and I grew curious to learn more.”
Over ten months I researched the literature and spoke with key informants to better understand the historical context and social connections in Russian speaking populations that contribute to low immunizations rates. Much of the vaccine hesitancy we find in Russian speakers stems from confusion and frustration with the US immunization schedule, concerns of adverse reactions to the vaccines and an inability to find a Russian speaking provider to answer their questions. The Washington State Department of Health conducted a series of Russian speaking focus groups to identify major themes, and all four groups requested an event with a Russian speaking provider to address immunization concerns in a community forum. With help from Spokane-based health service providers, we were able to develop the community forum parents asked for. At the forum, parents expressed their frustration and fears about childhood immunizations to a Russian speaking pharmacist who was able to answer their questions and explain why the US immunization schedule is different from their home countries. At the end of the meeting, the majority of surveyed participants said they enjoyed the forum and were able to have their questions answered by someone they trusted. 40% said the forum changed their minds about immunizations.
With the measles outbreak at Disneyland and whooping cough on the rise in Washington, media pundits and bloggers often lay the blame squarely on a mythical homogenous anti-vaccination group. The reality is people have a variety of concerns, and those of us doing immunization work should not assume why a particular group has fears about vaccines. This project allowed me to not only develop skills and learn new content, but also develop an appreciation for programs, such as Washington State Department of Health’s focus groups, that actively seek to understand health disparities and find culturally appropriate ways to address concerns within a community.
For additional information on how to develop a community forum addressing vaccine concerns for Russian speakers, contact Sara Jaye Sanford, WithinReach’s Immunization Action Coalition of Washington Program Coordinator at: (206) 830-5175 or email@example.com.