Immunization Rates in Maine

How can we improve?

Jessica Demers, Provider Relations Specialist

Objectives

1. Describe the trending of immunization rates for individual counties and the entire State of Maine over the past 5 years.

2. Describe methods and procedures to

incorporate into your office to increase immunization rates.

Maine Childhood Immunization Rates

Assessment Factors:

24-35 months of age Immunized as of 24 months

4 DTaP, 3 Polio, 1 MMR, 3 HIB

3 Hepatitis B, 1 Varicella, 4 PCV

2008-2009 Immunization Series 4-3-1-3-3-1

2010-present 4-3-1-3-3-1-4 (Prevnar added)

2008-2012 Statewide

Immunization Rate Comparison

Data Sources:

ImmPact Client Records Paper Provider Chart Assessments

63%

41%

48%

66%

73%

2008 2009 2010 2011 2012

Complete Vaccine Series

78% 83%

78% 82% 84%

2008 2009 2010 2011 2012

DTaP

87% 91% 89%

92% 93%

2008 2009 2010 2011 2012

Polio

86% 89% 87% 89% 90%

2008 2009 2010 2011 2012

MMR

84%

55%

72%

93% 95%

2008 2009 2010 2011 2012

HIB

81% 84%

81% 84%

87%

2008 2009 2010 2011 2012

Hepatitis B

82% 86% 84%

87% 88%

2008 2009 2010 2011 2012

Varicella

83% 87% 89%

2008 2009 2010 2011 2012

PCV

2008-2012 Immunization Rate

Comparison

Statewide & Individual Counties

Maine State Wide Rates Individual County Rates

63%

41%

48%

66%

73%

63%

30%

41%

50%

64%

2008 2009 2010 2011 2012

Androscoggin County

63%

41%

48%

66%

73%

79%

56%

64%

82%

89%

2008 2009 2010 2011 2012

Aroostook County

63%

41%

48%

66%

73%

56%

42% 46%

54%

64%

2008 2009 2010 2011 2012

Cumberland County

63%

41%

48%

66%

73%

82%

22%

40%

79% 78%

2008 2009 2010 2011 2012

Franklin County

63%

41%

48%

66%

73%

44%

25% 30%

37% 37%

2008 2009 2010 2011 2012

Hancock County

63%

41%

48%

66%

73% 70%

54%

63%

84% 83%

2008 2009 2010 2011 2012

Kennebec County

63%

41%

48%

66%

73% 68%

51%

71% 68%

76%

2008 2009 2010 2011 2012

Knox County

63%

41%

48%

66%

73%

19% 19%

28%

34%

50%

2008 2009 2010 2011 2012

Lincoln County

63%

41%

48%

66%

73% 68%

56%

49%

74%

84%

2008 2009 2010 2011 2012

Oxford County

63%

41%

48%

66%

73% 68%

38%

56%

74%

80%

2008 2009 2010 2011 2012

Penobscot County

63%

41%

48%

66%

73%

56% 57%

46%

54%

68%

2008 2009 2010 2011 2012

Piscataquis County

63%

41%

48%

66%

73%

36%

24% 19%

38%

52%

2008 2009 2010 2011 2012

Sagadahoc County

63%

41%

48%

66%

73% 70%

41% 45%

70% 74%

2008 2009 2010 2011 2012

Somerset County

63%

41%

48%

66%

73%

57%

19%

33%

58%

52%

2008 2009 2010 2011 2012

Waldo County

63%

41%

48%

66%

73% 69%

65% 65%

78%

86%

2008 2009 2010 2011 2012

Washington County

63%

41%

48%

66%

73%

62%

34% 37%

66% 71%

2008 2009 2010 2011 2012

York County

37%

50%

52%

52%

64%

64%

68%

71%

74%

76%

78%

80%

83%

84%

86%

89%

Hancock

Lincoln

Sagadahoc

Waldo

Androscoggin

Cumberland

Piscataquis

York

Somerset

Knox

Franklin

Penobscot

Kennebec

Oxford

Washington

Aroostook

County vs. County

2012 Adolescent Immunization Rates

Assessment Factors:

13-18 years of age

3 Hepatitis B, 1 Meningococcal, 2 MMR

2 Varicella, 1 Tdap

3 HPV (Females Only)

Data Source: ImmPact Client Records

40%

72% 68%

73%

54%

73%

38%

Series Hep B Meng MMR Var Tdap HPV

Adolescent Rates

How can we improve?

Accurate Record Keeping

• Verify EMR or chart immunization records match ImmPact. • Verify client status for MOGE opportunities. • Verify Hepatitis B hospital birth dose is recorded. • Data Exchange

Reminder/Recall

• Remind patients of their appointments. • Call and reschedule patients who miss appointments. • Use the reminder/recall function in ImmPact. • Use your EMR and create your own recall letters.

ImmPact Reporting Functions Home Graph (One Stop Shop)

19-35 month old clients Verify Immunization Data MOGE Run Reminder/Recall Flag Client Charts

Immunization Coverage Reports

Choose Client Ages Choose Antigens Great for School Entry and Adolescents HPV Rates to include Males

Parent Refusals • Education (Physician and Nurses) • Refusal Form • Offer Handouts • Hepatitis B, Varicella, MMR

Alternative Schedule Requests

• Offer Nurse Only Visits • Beware Invalid Doses

Check Minimum Interval & Ages Schedule Check ImmPact Forecaster Inform Scheduling Staff of Intervals

• Combination Vaccines

Involve Your Whole Office Staff

• RN’s, MA’s, CNA’s – Vaccine Storage • Medical Records – MOGE’s and Vaccine Records • Scheduling Staff – Meeting Minimal Intervals • Be PRO Vaccine

Maine Immunization Program • Universal Status • Educational Visits • AFIX Visits – Immunization Rate Improvement Workplan • Conferences • Website • A Telephone Call Away…

Questions?

Thank you.

Jessica Demers

Provider Relations Specialist

Maine Immunization Program 286 Water Street, 9th Floor

Key Bank Building Augusta, Me 04330

207-287-3862 jessica.demers@maine.gov