Indiana State Department of Health Immunization Program

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Indiana State Department of Health Immunization
Program

• Immunization Summit St. Joseph County
• April 16, 2008

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Agenda

• ISDH Immunization Program Overview
• Immunization Coverage Levels
• Children
• Adults
• Program Goals
• Questions

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Program Overview
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Program Overview

• The ISDH Immunization Program strives to prevent
  disease, disability, and death in children,
  adolescents, and adults through vaccination.
• Serves a population of 6.3 million Hoosiers
• 1.6 million are children 18 years of age or less
• 237,000 children are under 3 years of age

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Program Overview

• Vaccines for Children (VFC)
• Federally-funded
• Provides immunizations to eligible children under
  age 19
• Eligibility requirements
• Uninsured
• Medicaid Eligible
• American Indian or Alaska Native
• Served by a FQHC/RHC
• 45.8 of Hoosier children eligible in 2008
• 900 public and private providers enrolled in VFC

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Program Overview

• Delegation of Authority
• Allows FQHCs/RHCs to give authority to local
  health departments to immunize underinsured
  children in the health department
• PHS 317
• Provides immunizations to children with no other
  eligibility at specified public health facilities
• State-Funded Vaccine
• 11 million allocated from tobacco tax funds
• Providers qualify to receive state-funded vaccine
  if they are enrolled in VFC and use the
  immunization registry for inventory management
• Children 0-35 months not eligible for VFC at the
  VFC providers office are eligible for state
  funded vaccine

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Program Overview

• Adolescent and Adult Immunization
• Perinatal Hepatitis B Prevention
• Children and Hoosiers Immunization Registry
  Program (CHIRP)
• Non-mandatory, statewide population-based
  immunization registry
• Implemented in 2002
• Currently includes more than 2.9 million
  individuals with 23 million vaccinations

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Immunizations Provided

• In 2007, 1.7 million combined doses of federally
  and state purchased vaccine were distributed to
  public and private providers in the state

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Immunization Coverage
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Immunization Coverage

• Measured by completed immunization series
• 43133
• 4 doses of DTP (diphtheria, tetanus, pertussis)
  vaccine
• 3 or more doses of poliovirus vaccine
• 1 or more doses of MMR (measles, mumps, rubella)
  vaccine
• 3 or more doses of Hib (Haemophilus influenzae
  type B) vaccine
• 3 or more doses of HepB (hepatitis B) vaccine
• 431331
• 43133 plus 1 or more doses of varicella
  vaccine

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Immunization Coverage - Children

• Indiana immunization rates as of June 2007
• 79.7 of children 19 to 35 months had completed
  the 43133 series
• 76.5 of children 19 to 35 months had completed
  the 431331 series

Source National Immunization Survey (NIS)
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National Immunization Coverage - Children

• National immunization rates as of June 2007
• 80.4 of children 19 to 35 months had completed
  the 43133 series
• Coverage of 43133 was lowest among Black,
  non-Hispanic children at 76.0
• 77.5 of children 19 to 35 months had completed
  the 431331 series
• Coverage was lowest among Black, non-Hispanic
  children at 73.7
• Immunization rates stratified by race/ethnicity
  are not available at the state level.

Source National Immunization Survey (NIS)
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National Immunization Coverage, Indiana vs. U.S.
National, 19-35 Months of Age,2000-June 2007
Source National Immunization Survey (NIS)
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National Immunization Coverage 19-35 Months of
Age, 2002-June 2007
Source NIS
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National Immunization Coverage, Indiana vs. U.S.
National, 19-35 Months of Age, 2002-June 2007
Source National Immunization Survey (NIS)
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National Immunization Coverage 19-35 Months of
Age, 2002-June 2007
Source NIS
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Indiana Immunization Coverage Adults
Influenza Vaccine

• Adults reporting receiving a flu shot in the last
  year
• 31 of all adults aged 18 and older
• Adults reporting receiving influenza vaccine
  intranasally in the last year (FluMist)
• 0.6 of adults aged 18 and older

Source 2006 Indiana Behavioral Risk Factor
Surveillance System (BRFSS)
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Indiana Immunization Coverage Adults
Influenza Vaccine (Flu Shot and FluMist)
Source 2006 BRFSS
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Indiana Immunization Coverage Adults
Influenza Vaccine (Flu Shot and FluMist)
Source 2006 BRFSS
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Indiana Immunization Coverage Adults
Pneumococcal Vaccine

• The pneumococcal vaccine is usually given only
  once in a persons lifetime.
• Pneumococcal polysaccaride vaccine is recommended
  at age 65 or older unless certain risk factors
  are present.
• Adults reporting ever having a pneumonia shot
• 21.5 of adults aged 18 and older
• 54.1 of adults aged 65-75
• 70.2 of adults aged 75 and older

Source 2006 Indiana Behavioral Risk Factor
Surveillance System (BRFSS)
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Indiana Immunization Coverage Adults
Pneumococcal Vaccine
Source 2006 BRFSS
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Indiana Immunization Coverage Adults
Pneumococcal Vaccine
Source 2006 BRFSS
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Indiana Immunization Coverage Adults
Hepatitis B Vaccine

• 28.7 of Indiana adults aged 18 and older report
  having ever received the hepatitis B vaccine.
• The hepatitis B vaccine is completed after the
  third shot is given.
• 5.8 of adults aged 18 and older report having
  one of the following risk factors for hepatitis
  B
• Have hemophilia and have received clotting factor
  concentrate
• Are a man who has had sex with other men
• Have taken street drugs by needle
• Have traded sex for money or drugs
• Have tested positive for HIV
• Have had sex with someone who would answer yes
  to any of these statements
• Have had more than two sex partners in the past
  year

Note Those reporting risk factors are not
necessarily those who have been vaccinated.
Source 2006 BRFSS
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Indiana Immunization Coverage Adults
Hepatitis B Vaccine and Risk Factors for
Hepatitis B
Note Those reporting risk factors are not
necessarily those who have been vaccinated.
Source 2006 BRFSS
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Program Goals
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Program Goals

• Increase the immunization rates of two-year-old
  children
• Increase the proportion of adults who are
  vaccinated annually against influenza and who are
  ever vaccinated against pneumococcal disease
• Increase the proportion of children who receive
  all vaccines that have been recommended for
  universal administration through 6 years of age

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Program Goals

• Increase the proportion of providers who have
  measured the vaccination coverage levels among
  children in their practice populations within the
  past two years
• Increase routine vaccination coverage levels in
  adolescents
• Increase hepatitis B vaccine coverage among high
  risk populations
• Increase the proportion of providers and who
  participate in population-based immunization
  registry

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Questions?
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Amanda Mizell, DirectorImmunization Program

• Office 317-233-7010
• amizell_at_isdh.in.gov