Giving Every Child a Shot at Life
I recently had the opportunity to attend the Shot@Life Champion Summit, a gathering of vaccine advocates from across the country who come together each year to learn about the crucial role the U.S. plays in supporting global immunizations. Advocates also learn the powerful impact of advocacy through trainings and meetings with Congressional offices on Capitol Hill.
Shot@Life, a campaign of the United Nations Foundation, aims to ensure that children around the world have access to life-saving vaccines. The campaign works to build a group of Champions (advocates), who will dedicate their voices, time, and support to standing up for childhood in developing countries.
At the Summit, I heard from several Champions who are experts in the areas of vaccines, global health, and international development. The most powerful speaker for me was Geeta Rao Gupta, a senior fellow at the UN Foundation who has worked to improve the lives of women and girls around the world. She focused on the value of vaccines for women, and not just in the obvious ways, like preventing cervical cancer. “When we talk about the statistics of infant mortality, we rarely talk about grief,” she said. She shared the heartbreaking story of her great-grandmother, who died of tuberculosis in her early thirties after losing five of eleven children in their infancies. I don’t think many of us living in Washington today can imagine how painful these losses must have been for her. And while it can be easy, in our day-to-day work, to focus on the numbers and rates, it’s a powerful reminder of why those numbers and rates matter. Dr. Gupta reminded us that vaccines don’t just “save lives” – they prevent grief, and allow mothers to focus their energies on caring for healthy children.
Dr. Gupta emphasized how fortunate we are to live during the age that we do, with advancements in vaccines and general health. However, developing countries are still in need of these valuable resources. And where vaccines could prevent an estimated 2.5 million deaths among children younger than age 5 around the globe, 1 child still dies every 20 seconds from a disease that could have been prevented by a vaccine. Therefore, the U.S. strives to provide access and education around vaccines through a variety of ways. Did you know the U.S. Centers for Disease Control is key in leading worldwide efforts to eradicate polio and measles? Or that USAID is a key partner of Gavi, the Vaccine Alliance, which creates immunization access for the world’s poorest countries, immunizing half a billion children? Even the U.S.’s contribution to UNICEF helps save lives, as they deliver vaccines to 45% of the world’s children. The U.S. is a leader in providing vaccine assistance globally, as well as here at home by providing funding to various organizations working at the community level.
Being a local organization that promotes immunizations, our work at WithinReach is also part of a global community. We’re reminded of that every year, as American travelers bring back vaccine-preventable diseases from across the globe. “Disease anywhere is disease everywhere” with our interconnected world and the ease of travel. Diseases that have been long rare at home are still prevalent in many other areas of the world. That is why it is important that we advocate and create awareness around vaccine-preventable diseases through our community members, our partners and state leaders. If you’re interested in learning more about how you can help every child have a shot at life, check out shotatlife.org.
New frontiers in vaccine hesitancy research: a border-spanning collaboration
An exciting project is taking shape at WithinReach. After nine years of extraordinary work in the vaccine hesitancy field, Vax Northwest is embarking on a new project, and we’re doing so with new partners—
a wide range of researchers from, or interested in, the midwifery community who come from both the United States and Canada.
Midwives are a very influential group of health care providers. Midwives attend 8.3% of births in the United States , but their knowledge, attitudes and beliefs about vaccines have not been robustly studied. Likewise, we know very little about the people who seek care from the midwifery community. In our attempt to engage as many leverage points as possible in building vaccine confidence, Vax Northwest has elected to focus on the midwifery community.
On January 10th, more than 20 researchers and practitioners from the fields of midwifery, naturopathy, allopathic medicine, public health, pediatrics, and anthropology, among others, came together at WithinReach to define a research agenda related to midwives (and other perinatal providers to a lesser extent). We had a rich and varied conversation that culminated in three research questions that Vax Northwest and our partners will address going forward:
- 1) What are the knowledge, attitudes, and beliefs of midwives toward vaccines? (Are they advocates of vaccines?
Do they want to be advocates of vaccines? What support is needed to become better vaccine advocates?)
2) What are the characteristics of people who seek midwifery care? (Are they more likely to be vaccine hesitant? Are they dissatisfied with ‘traditional’ medicine?)
3) What is the vaccination status of children in Washington, by the type of provider who attended their birth (midwife, physician, etc.)? Is there an association between provider type and immunization status?
“As an observer, it was a fascinating experience to listen to experts in various fields discuss current information and determine what new information is needed before deciding on specific research questions. Since the influence of the midwifery community on the decision to vaccinate children has not been studied, it will be exciting to see how these new research questions will help us better understand vaccine hesitancy” noted Cristina Cardenas, a WithinReach AmeriCorps service member, who participated in the meeting and has a special interest in immunizations.
Making policy, decisions, or interventions based off anecdotal evidence can be ineffective, or even worse, backfire. That’s why Vax Northwest has such a strong focus on creating a research foundation before we act. After several years of sharing the informative and well-received results of our previous research, we’re excited to be breaking new ground with this project and adding to the vaccine hesitancy research base. As always, we’ll do so in collaboration with the right partners with the goal of keeping all Washington families thriving and healthy.
Stay tuned for more updates!
Vaccines Are Safe. Vaccines Are Effective. Vaccines Save Lives.
You may have heard in the news about the possible development – and the possible non-development – of a new vaccine safety commission by the executive branch. Vaccines have been proven to be one of the safest and most effective ways of preventing illness ever developed, and have saved the lives of hundreds of thousands. Their safety is paramount, especially because they are so widely used by healthy children and adults. But the creation of a federal commission on vaccine safety seems unnecessary because we already have a robust system to monitor and detect problems with the use of vaccines. The creation of such a commission would cast doubt on the use of these life-saving treatments and decrease utilization of vaccines, causing significant harm to individuals and the community at large. We stand with our partners in healthcare, public health, and many parents and community members when we say: Vaccines are safe. Vaccines are effective. And vaccines save lives.
We asked Neil Kaneshiro, MD, for his thoughts. He’s been a pediatrician in Washington for more than twenty years, and is currently serving as chair of the Immunization Action Coalition of Washington. Here’s what he had to say:
“As a practicing pediatrician, I have recommended, administered and personally used standard vaccines for over 20 years in thousands of patients and have not seen any reason to hesitate using vaccines when given appropriately according to national guidelines. If you really look at the data, there are far less significant adverse reactions to vaccines than to antibiotics given for ear infections or pneumonia. The diseases prevented through the use of vaccines are not as well-known now because of our preventive effort, but they are real and can return with a vengeance if immunization rates wane. Few people today remember the fear parents had that their healthy children might contract polio and suffer in an iron lung machine. You just don’t see that anymore precisely because of vaccines. Rumors and conspiracy theories are rampant on the web, but the scientific evidence is clear that vaccines are safe and effective and they do save lives. We need to do everything we can to promote increased use of vaccines and not scare people away.”
Promoting trusted sources of information about vaccines is crucial. Read what the American Academy of Pediatrics and the American Academy of Family Physicians have to say in response to the recent news on vaccines.
HPV Prevention in High School: A Guest Blog
Paul and Claire are juniors at Nathan Hale. Paul initially got involved when his mom asked him if he would support her in a public health panel sponsored by the Group Health Foundation, which focused on HPV awareness. Paul recruited Claire for the effort too, and their remarks were so well-received that after the panel discussion they were approached by public health nurse Lauren Greenfield from Public Health–Seattle & King County about an HPV campaign to be launched at six Seattle public schools, including Nathan Hale. Their history with this brilliant project is detailed below. Enjoy! -Todd
When we both agreed to be a part of this campaign (to spread awareness about the importance of HPV vaccine at Nathan Hale and get students immunized at the teen health center), we had no idea what to expect. But despite that, we both said yes for the same reason: we realized that this campaign was a way for us to help and have a positive impact on our community. Human Papillomavirus (HPV) cancers and disease have affected the lives of many people and will continue to if nothing is done, and if immunization rates in our state remain low. People have been looking for a cure for cancer for a long time, and the thought of finding one seems impossible. But what people don’t realize is we have something even better than that. We have a way to PREVENT cancer. And it’s right at our fingertips. The HPV vaccine is of great importance because it has the ability to save thousands of lives from future cancers. And our job is to make sure that people, especially our peers, understand this.
When we started the campaign, there was no plan to work off of, no template or outline of what we were supposed to do. We were basically winging it. At our first meeting with our advisor, she asked us, “What are your ideas? What do you guys want to do?” This was one of the best features of the opportunity; it was up to us to come up with ideas on how to run a successful campaign, and it was our ideas that mattered the most. This campaign taught us many important skills, including leadership organizational skills. Running into many obstacles, we’ve learned to be persistent in our goals. The biggest challenge, though, was always juggling this on top of schoolwork, sports, and other activities we do outside of school—especially since it was just the two of us.
As for the future of the campaign, we have high hopes and many plans. We plan to continue running the campaign at Nathan Hale, and this year hope to create an HPV Awareness Club at our school. The club will not only educate people on the topic, but also the group can help with certain projects throughout the year that are part of the campaign. We also hope to get speaking time at an assembly this year, and maybe do a schoolwide HPV awareness week. And of course, our goal every year is that more and more people at our school get vaccinated. Finally, as a more widespread goal, we hope students at other schools around the state take on the challenge that we have and raise awareness about HPV, and the vaccine that prevents certain HPV cancers and disease, at their schools.
It’s wonderful to see young people getting involved and speaking up for the health of their peers. Many thanks to Paul and Claire for their great work!
Get ready for the first annual Washington State Immunization Summit
The immunization team at WithinReach is using its well-honed event planning skills on a new endeavor. On April 26, 2017, we will host the first ever (and hopefully annual) Washington State Immunization Summit at the SeaTac Conference Center. Guided by best practices nationally, we have decided to offer an annual summit for immunization stakeholders from any sector across the state. Continuing education credits may be available (see website for details).
So why are we doing this? Immunization is complicated; it is both a precise science and a complex social phenomenon, and the strategies needed to be successful evolve constantly. Washington leads the country in the immunization field in many ways (our hesitancy research, our cutting-edge HPV work, etc.), and this is yet another way that we want to support our state in taking the lead. In creating this summit, our goal is to offer responsive, cutting-edge immunization education to our partners. There is plenty of immunization education out there, but the content is usually pre-defined by the creators. In this case, we have been surveying our constituents about what they want and need from us. Three specific areas of interest emerged at the top of the list:
- Vaccine hesitancy
- The use of data and information systems to improve rates
- Reaching underserved populations
While the agenda is still coming together, we are thrilled to feature our colleague Dr. Doug Opel of Seattle Children’s Hospital, who will deliver a talk on the intersection of ethics and vaccine hesitancy. If you’ve ever seen Dr. Opel live or read his work, you know how powerful he is as an educator. Also, Dr. Clarissa Hsu of the Group Health Research Institute will share preliminary results from a study Vax Northwest has commissioned that examines the attitudes and beliefs of families in Washington who are delaying or skipping vaccines. The Washington State Department of Health – Office of Immunization and Child Profile will lead an excellent session on the use of data and information systems to bring up rates. And an as-yet-undetermined session will focus on reaching underserved groups.
WithinReach is thrilled to offer this learning opportunity, and we are committed to making this part of our ongoing suite of services offered to Washington immunization professionals.
Interested? Good news! You can learn more and register today. Please spread the word widely.
Don’t Panic: Zika, the Summer Olympics, and You
If you only read this paragraph, here’s why the Olympics happening in the midst of Rio’s Zika outbreak shouldn’t worry you: First, Zika is primarily spread by two species of mosquito–known as Aedes aegypti and Aedes albopictus–that don’t live in Washington, so the chance that it could spread widely here is pretty close to nil. Second, for most adults it’s a pretty mild illness. Pregnant women need to be most cautious because their babies are at the highest risk of severe consequences.
If you travel anywhere impacted by Zika, like Rio or even Puerto Rico, you can prevent mosquito bites – and therefore Zika – by using bug spray (DEET, picaridin, IR3535, OLE, and PMD have been proven safe and effective). Just as important, wear clothing that covers your arms and legs, and “mosquito-proof” your accommodations by closing or screening doors and windows and/or using a mosquito net.
Zika is typically a mild illness in adults, marked by fever, rash, joint pain, and red eyes. But it’s linked to a serious birth defect in newborns called microcephaly – an unusually small brain and skull. So if you’re pregnant or planning to become pregnant, extra precaution is recommended, including postponing travel to impacted areas if possible. Because Zika can also be spread through sex with a man, always use a condom with a male partner who has recently traveled to an area with Zika (even if they’re not showing any symptoms). This may mean using a condom throughout your pregnancy, or waiting to conceive for at least eight weeks if your male partner has no symptoms of Zika.
Chances are, most of us in Washington won’t be exposed to Zika. So why should it matter? Well, our immunization team at WithinReach can think of a few reasons. It’s a good reminder that in an age of global travel, infectious diseases are only a plane ride away. Already, 15 cases in Washington have been confirmed among recent travelers (as of July 20th). Many of the diseases we vaccinate against are equally easy to import into Washington – and without the need for a vector, like a mosquito, they can spread much more easily when they do arrive. That’s why it’s so important to protect our communities through immunization.
Zika also has one thing in common with a disease we routinely vaccinate against: rubella. When a pregnant mom becomes ill with rubella, it can have terrible consequences for her developing fetus. In 1964, the U.S. experienced a huge rubella outbreak that affected 50,000 pregnant women and led to thousands of miscarriages and 20,000 cases of congenital rubella syndrome, in which babies are born with symptoms including blindness, deafness, heart defects, and cataracts. Now that we have the MMR (measles, mumps, rubella) vaccine, very few American babies are born with congenital rubella syndrome – primarily only when their mother is infected during international travel. Sound familiar? With Zika, like rubella, we know that protecting pregnant women is our biggest priority. Hopefully, one day we will have a vaccine to help us do so.
So whether you enjoy watching the world’s top athletes compete in Rio or on your TV, have a safe and healthy summer! And if they inspire you to get out and be active, all the better – just don’t forget your bug spray.
Congratulations to Washington’s Immunization Award Winners!
Every other year, the Immunization Action Coalition of Washington (IACW) recognizes people and organizations in our state that are truly going above and beyond to protect our communities from vaccine-preventable diseases. This year, we presented the awards at a special coalition meeting on April 20, during National Infant Immunization Week.
The 2016 IACW Collaborator award goes to the Auburn School District School Nurses, represented by Jan Schneider, Jill Olson, and Tami Petrina. Together with the district’s health technicians, they reduced the number of students in their district who were out of compliance (meaning their immunization paperwork wasn’t submitted properly) by two-thirds, from 852 to 295. These numbers represent countless hours spent researching immunization records and contacting students, parents, guardians, and health care providers. In one example of how far-reaching this work can be, when one student visited their health care provider to catch up on their immunizations, they also received a much needed eye exam and glasses. Thank you, Jan, Jill, Tami, and your colleagues for your hard work to ensure that Auburn’s students are protected from vaccine-preventable diseases.
Our 2016 IACW Advocate is Becky Doughty, Health Services Coordinator of Spokane Public Schools. She has worked diligently to coordinate, review, and update immunization records for each student in her district – a total of 35,000! Working closely with school staff, Becky achieved a decrease in kindergarten out of compliance rates from 24.6% to 0.9%. Additionally, she supported the development of pop-up clinics to provide immunizations to students in schools. In addition to her work in schools, Becky is founder and director of the Inland Northwest Transitional Respite Program, which provides shelter-based respite care to men and women experiencing homelessness. Typically, medical respite care involves acute and post-acute care for those too ill to recover on the streets, but Becky has ensured that preventive measures, including vaccines, also reach this very vulnerable population. She also implemented a program to ensure that all staff at the Respite Program are fully up to date with hepatitis B and influenza vaccines.
Finally, we partnered with the Washington State Department of Health to recognize Dr. John Dunn as the 2016 CDC Childhood Immunization Champion for Washington. Whether it’s appearing on local news segments, answering colleagues’ questions about vaccines, providing care to patients and their families, or serving on numerous local boards that make decisions about vaccines in the state of Washington, Dr. Dunn steps up to support vaccines. He serves on the Washington Vaccine Association, the Vaccine Advisory Committee, and the Vax Northwest Oversight Committee. He also chairs the Immunization Program at Group Health. In these positions, he ensures that policies and practices are in place to keep state immunization levels high. Through his research work at Vax Northwest, Dr. Dunn continues to learn about vaccine hesitancy and apply his findings to his everyday interactions with children and their families.
The work that Jan, Jill, Tami, Becky, and John do every day touches each of us – when we go about our daily lives in a Washington State that is safe from the diseases that vaccines prevent. Personally, I’m grateful for the opportunity we have at WithinReach to collaborate with, support, and recognize such fabulous partners!
MyIR makes accessing immunization records easy
Now, you too can access your own and your child’s immunization records online through a portal called MyIR. It’s never been so easy to view and print your immunization records! It’s simple (and free) to sign up. The secure system even allows you to print out a pre-filled Certificate of Immunization Status (CIS), which is the form required for entry to schools and child cares, without an additional visit or call to your healthcare provider. This makes it so much more convenient to provide required immunization records. If your little ones are headed to camp this summer or starting school in the fall, try it out!
I signed up recently, and MyIR showed me that I’m due for a second dose of Hepatitis A vaccine – I got the first dose before some travel last year, and two doses are needed for full protection. Plus, now I’ll know when it’s time for that tetanus booster!
However, there’s one caveat: there may be some vaccines you or your family received that don’t appear on the immunization record in MyIR, such as the human papillomavirus (HPV) vaccine. HPV vaccine is sometimes given by a healthcare provider confidentially. Since MyIR doesn’t know which HPV vaccines were given confidentially or not, all HPV vaccinations are hidden on immunization records in MyIR. Contact your healthcare provider if you think you need a more complete record of your or your family’s immunization history.
You can get started today at https://wa.myir.net/.
2016 Legislative Summary
Written by Carrie Glover, Senior Policy Manager
At about 11:00pm on March 29th the 2016 legislative session was adjourned. This year was a ‘short session’ that was mostly focused on writing a supplemental budget.
WithinReach did very well this session, including securing funding for an immunization validation tool and a school module within the Immunization Information System (IIS), which was our top priority going into 2016. It was a great year of working with our partners in Olympia and we made real progress in breaking down barriers that prevent families from living healthy lives.
We also supported some additional issues as they emerged through session, and those also fared very well. Below is a summary of the outcomes of our top priorities as well as other issues we supported this session that had successful outcomes.
Here is a brief summary of where we landed in the budget for our priorities:
Immunization Validation Tool & School Module within the IIS (budget only)
- Budget ask: $511,000>
- Final Amount funded: $511,000
Developmental and Autism Screenings for Medicaid (budget only)
- Budget ask: Maintain current funding
- Outcome: No cuts were made to the screenings
HB 1295: Breakfast After the Bell (budget and bill)
- Bill: Require all high needs schools to offer breakfast after the bell
- Budget ask: $2.692 million for startup grants
- Outcome: Unfortunately the Breakfast After the Bell legislation did not pass this year. Since the bill didn’t pass, the startup grants also were not funded in the final budget
Healthiest Next Generation (budget only)
- Budget ask: fund staff positions at OSPI & DEL for this initiative
- Outcome: Unfortunately this was not funded in the final budget
Other issues we supported that were successful:
HB 2877: Expanding SNAP Distribution dates
- Bill: Expand the distribution dates for SNAP beneficiaries from the 1st through 10th of the month to the 1st through the 20th of the month
- Budget ask: funding needed to implement the system change
- Outcome: The bill passed with a great deal of support and $300,000 in funding was included for implementation in the final budget
HB 2439: Mental health services for children and youth
- Bill: Increasing access to adequate and appropriate mental health services for children and youth including establishing a workgroup to identify barriers in accessing mental health services, report on the status of access to services, expand the Partnership Access Line (PAL), and require coverage for annual depression screenings according to the Bright Future guidelines
- Budget ask: funding needed for implementation of the workgroup, inventory of services, expansion of the PAL line, and the depression screenings.
- Outcome: The bill passed, though with only the workgroup and inventory of services. The PAL line was funded in the final budget even though it wasn’t included in the final bill. Unfortunately the depression screenings weren’t funded or included in the bill.
SB 5143: Childhood Immunization Resources
- Bill: Requires DOH to develop resources for expecting parents about recommended childhood immunizations.
- Outcome: This bill passed with a great deal of support and some of our WithinReach staff were able to be at the bill signing with Governor Inslee.
Learn more about the guiding principles of our policy work.
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 firstname.lastname@example.org.
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: email@example.com.
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!