Travel Health of Williamsburg

I have been in nursing for more than 30 years and have never used a tool like VIIS (the Virginia Immunization Information System). VIIS is the best thing ever invented and everyone in the state should be using it. It has saved me so much time. I do not have to call the providers or the local health departments as much for shot records. Most of my patients are in VIIS with a partial or full record.

VIIS saves the day!

I was able to help a young lady who had come to my office for travel vaccines in the past. She had returned to the U.S. and took another trip to New York. The young lady was involved in an accident and was rushed to a local hospital. The hospital asked if she had received the Td vaccine in the past. The young lady did not know. She called me for help and advice. I was able to find her immunization record in VIIS which showed that she had received the Td vaccine. The young lady did not have to pay for a vaccine that was not needed.

Noticed Vaccine Trends in VIIS

Since gaining access to VIIS, I have noticed trends in the administration of vaccines. A few of the trends are:

  • Children between the ages of 14 – 18 years old do not have the 2nd Varicella. This vaccine is highly recommended for travel abroad.
  • Infants should be vaccinated with MMR and Varicella before traveling abroad. Even if it is before their required age for the vaccines. The infants are at risk if they do not have these vaccines.
  • Patients are getting unnecessary multiple doses of Pneumococcal Polysaccharide vaccine.

VIIS is a very user friendly system. I encourage all providers who administer vaccines to sign-up with VDH and get trained on this system today!

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May/June 2019

Change to School Requirement for Tdap

The Advisory Committee on Immunization Practices (ACIP) recommends that adolescents routinely receive meningococcal conjugate; tetanus, diphtheria, acellular pertussis (Tdap); and human papillomavirus (HPV) vaccines.  Centers for Disease Control and Prevention (CDC) routinely recommends Tdap as a single dose for those 11 through 18 years of age with preferred administration at 11 through 12 years of age.  If an adolescent is not fully vaccinated, check the ACIP recommendations and catch-up schedule to determine what is indicated.  Those who receive a dose of Tdap or diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP) at age 7-10 years inadvertently or as part of the catch-up series should still receive the routine dose of Tdap at age 11-12 years.

To align with ACIP, the Virginia General Assembly passed legislation effective July 1, 2019 affecting school immunization requirements for Virginia.  The legislation changes §32.1-46 of the Virginia Code which relates to immunizations, by requiring the booster dose for acellular pertussis vaccine prior to seventh grade.  Therefore, in the upcoming 2019-20 school year, seventh graders, not sixth graders, will be required to have received the Tdap vaccine. All new students enrolling into grades eight through twelve must also have a Tdap booster.  Although a student who has received Tdap vaccine at age 7 years or older will meet the school vaccination requirement for Tdap, it may not comply with CDC recommendations

National Infant Immunization Week (NIIW)

This year marks the 25th anniversary of National Infant Immunization Week (NIIW). From April 27-May 4, 2019, NIIW will highlight the importance of protecting infants from vaccine-preventable diseases and will celebrate the achievements of immunization programs in promoting healthy communities throughout the United States.  NIIW is an annual observance to highlight the importance of protecting infants from vaccine-preventable diseases and celebrate the achievements of immunization programs and their partners in promoting healthy communities. As part of this week, CDC will announce the winners of its CDC Childhood Immunization Champion Award here: https://www.cdc.gov/vaccines/events/niiw/champions/profiles.html
This annual award recognizes individuals who make a significant contribution toward improving public health through their work in childhood immunization. Virginia’s nominee is Donna Deadrick, Carilion Childrens Pediatric Medicine, Roanoke.

Shipping Hours

CDC requires at least 1-4 hour window as a minimum for provider hours of operation.  In order for shippers to be able to deliver vaccine, providers must be on site with appropriate staff available to receive vaccine at least one day per week other than Monday, and for at least four consecutive hours during that day.

Vaccine Information Statements (VISs)

These are the VISs that have changed since 2018.

  • DTaP (8/24/18)
  • Hepatitis B (10/12/18)
  • Measles/Mumps/Rubella (MMR) (2/12/18)
  • Measles/Mumps/Rubella & Varicella (MMRV) (2/12/18)
  • Meningococcal ACWY (MenACWY & MPSV4) (8/24/2018)
  • Rotavirus (2/23/18)
  • Varicella (Chickenpox) (2/12/18)
  • Zoster / Shingles (Live) (2/12/18)
  • Zoster / Shingles (Recombinant) (2/12/18)

CDC VISs are available here: https://www.cdc.gov/vaccines/hcp/vis/current-vis.html

Gold Star Awards (Feb/Mar)

Outstanding VVFC Compliance

Chesapeake Peds. Gr. Bridge, Chesapeake
Chesapeake Peds. Oakbrooke, Chesapeake
Commonwealth Pediatrics, Richmond
Monument Avenue Pediatrics, Richmond
Pine Grove Pediatrics, Manassas
Sacoto Pediatrics, Falls Church
Sentara Pratt Med. Gp. Peds., Fredericksburg
Wythe Physician Practices, Max Meadows

Adult Vaccine Update

Outbreak Resource

Hep A and Measles outbreaks are occurring in multiple states across the U.S. increasing awareness of the importance of protection through vaccination. Helpful resources can be found here:

  • The Immunization Action Coalition (IAC) resource for healthcare professionals titled Hepatitis A and Hepatitis B Vaccines: Be Sure Your Patients Get the Correct Dose. Changes were made to incorporate the recently licensed 2-dose Heplisav-B vaccine. http://www.immunize.org/catg.d/p2081.pdf
  • CDC Measles website for Healthcare Professionals www.cdc.gov/measles/hcp

Heplisav-B

Heplisav-B, manufactured by Dynavax is available to order on the Adult Order Form.  Refer to the April 20, 2018 MMWR: Recommendations of the ACIP for Use of Hepatitis B Vaccine with a Novel Adjuvant: https://www.cdc.gov/mmwr/volumes/67/wr/mm6715a5.htm

VIIS and the Virginia Early Hearing Detection and Intervention Program Collaboration

All newborns born in the state of Virginia are required by law to receive a newborn hearing screen prior to discharge from the hospital. In 2016, the hearing screening rate in Virginia was 99.2%. The Virginia Early Hearing Detection and Intervention (EHDI) Program monitors the newborn hearing screening of all babies born within the state of Virginia, as well as hearing re-screening and diagnostic records for all infants from birth to 36 months of age that reside in the state of Virginia. This information is maintained in an online database called the Virginia Infant Screening and Infant Tracking System (VISITS).

The hearing screening test is performed on all newborns shortly after birth. It is the first step in a process designed to identify children with hearing loss as early as possible, to ensure that all newborns can benefit from interventions that will help them develop to their full potential. Language development is largely dependent on hearing and begins very early in a child’s life. Re-screening a newborn prior to 1 month of age and diagnosing a hearing loss prior to 3 months of age is important in providing the child with appropriate resources in a timely manner. These resources will help children achieve their best linguistic and literacy abilities, and improve their chances for educational success.

In order to ensure appropriate and timely follow-up hearing rescreens, the Virginia EHDI program has collaborated with the Virginia Immunization Information System (VIIS), to allow the child’s Primary Care Provider (PCP) easy access to view the newborn hearing screening results. The Virginia EHDI program and VIIS are scheduling site visits and/or GoTo meetings with PCP offices to provide training and education to view the screening results and discuss recommendations for children in need of rescreening. If a child fails or misses the newborn hearing screening in the hospital, as the PCP, you can make an audiology referral to ensure the child has a hearing rescreen or diagnostic evaluation performed. For a list of preferred audiology facilities within the state of Virginia you may visit the http://EHDIPALS.org website or refer to the back of the letter you receive from the Virginia EHDI program with hearing screening results and recommendations.

If you are interested in scheduling a site visit or if you would like more information about the Virginia EHDI Program contact Kathleen Watts: Kathleen.Watts@vdh.virginia.gov or Deepali Sanghani: Deepali.Sanghani@vdh.virginia.gov via phone at 804-864-7719 or fax at 804-864-7771. Please visit the VA EHDI Program website at: http://www.vdh.virginia.gov/early-hearing-detection-and-intervention/