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Vaccine Preventable Disease in NJ: Improving Outcomes. Peter Tabbot, NJCEPH Project Director Mitchel Rosen, UMDNJ-School of Public Health MLC-3 Open Forum - State Sharing Session September 2009. NJ Public Health System. NJ Department of Health and Senior Services

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Vaccine preventable disease in nj improving outcomes

Vaccine Preventable Disease in NJ: Improving Outcomes

Peter Tabbot, NJCEPH Project Director

Mitchel Rosen, UMDNJ-School of Public Health

MLC-3 Open Forum - State Sharing Session

September 2009

Nj public health system
NJ Public Health System

  • NJ Department of Health and Senior Services

  • County, regional and municipal departments

  • Local Boards of Health

  • Practice Standards of Performance for Local Boards of Health

  • Performance evaluation instrument

Selecting target areas
Selecting Target Areas

  • Process Outcome: Steering Committee

  • Health Outcome: Applicants (ranked)

  • VPD selected by both mini-collaboratives

  • The composition of our mini-collaboratives…

Selecting participants
Selecting Participants

  • Online application process; bidder’s conference call

  • Seven applicants

  • Scoring

  • Final selection:

    • Quality of application

    • Capacity & sustainability

    • Geography & demographics

Two groups two approaches
Two Groups, Two Approaches


  • Intent was to educate non-vaccinating parents about safety/importance of childhood vaccinations

  • Sought out local data as first step (PLAN)

  • Lack of reliable/complete/ current data became a concern

  • Result: Shift in aim statement / focus area

Monmouth gphp
Monmouth GPHP

What the Data Showed

  • Immunization rates*

    • ‘Adequate’ compliance until 12 mos.

      • Not HP2010, but close….

      • At 24 months, rate dropped to 69%

  • But still incomplete data

    • Shifted from education to data collection

      • Needed to gather reliable local rates

      • Needed to implement process to do so

Monmouth GPHP

  • Developed retrospective audit process for use during routine pre-school immunization audits


    • Assessed and selected existing immunization audit form

    • Develop sampling protocol of 10% of pre-school population, aged 36 - 60 mos.


    • Each dept. performed audits, Feb - May ‘09

    • Assessed local Immunization Exemption reports

Monmouth gphp1
Monmouth GPHP


  • 818 records collected

  • CoCASA employed by epidemiologist to assess immunization rates

  • Reports shared and reviewed by MC members in July


  • MC is evaluating frequency of repeat audits

  • Upcoming NJSIIS implementation will influence decisions

Monmouth gphp2
Monmouth GPHP

Next Steps

  • Careful analysis of data to define education effort

  • Development of targeted education

  • Dissemination of materials as appropriate

Southern gphp
Southern GPHP

  • Focused on development of HCP ‘tools’ for patient education (re: childhood immunization)

  • Focus on prenatal, including: OB/GYN, childbirth educators and others

    • Surveyed HCP to assess preferred mode of education materials

Southern gphp1
Southern GPHP


  • Assessed HCP preferred mode of education materials

  • “Tip cards” selected as mode of education

  • Developed list of 36 objections to immunizations for ‘counter’ statements


  • Divided ‘objections’ among GPHP participants for response development

  • Researched science-based responses; credible sources for additional information

Southern gphp2
Southern GPHP


  • Evaluate each objection response for validity, clarity of message, etc..


  • Pilot tip cards with locally-identified HCPs

  • Partner with local vaccine producer to assist with material review/development

  • Distribute ‘toolkit’ in fall to identified providers



  • Improved planning capacity for those involved

  • Increased regional collaboration

  • Established foundational QI knowledge and application

  • Developed unified PH response to anti-vaccination voice



  • Development of replicable audit process to gather local immunization data

  • Gathering of reliable baseline immunization data

  • Development of educational ‘toolkit’ that can be distributed regionally and replicated by other departments

Next steps
Next Steps


  • Develop education effort to address findings

    (possibly apply Southern GPHP’s)

  • Continue to review exemption reports


  • Implement campaign to provide HCP with easy-to-use resources for parental education


  • Mini-collaboratives to participate in ‘round two’ learning sessions

  • All story boards/resources to be posted on NJCEPH website

  • Retreat and implicit/designed mentoring

  • Showcase at future local and regional conferences