This document summarizes discussions from stakeholder meetings about improving Texas' immunization rates and immunization information systems. Key points discussed include expanding the immunization registry to track adults, creating data linkages between provider systems and public health databases, enabling inter-state data sharing, and providing incentives for full registry participation. Challenges around vaccine financing, safety concerns propagated by celebrities, and border issues with immunization records were also addressed. Next steps proposed were further discussions on immunization information systems, vaccine financing and reimbursement, addressing vaccine safety questions, and advocacy training.

1. Recap of Stakeholder MeetingsRecap of Stakeholder Meetings
Anna C. Dragsbaek, JD
Texas Immunization Summit 2008

3. 75
80
85
Texas Immunization Rates
4:3:1:3:3:1
"If you've done it, it
ain't braggin'."
60
65
70
2002 2003 2004 2005 2006 2007 2010

8. Immunization Information Systems
Vaccine Financing and Reimbursement
Educating Public About Vaccine Safety

10. Expand to a Lifespan Registry
• Adults should have the right to use ImmTrac to
protect their immunization records if desired.
• Data should stay in the system so that it is• Data should stay in the system so that it is
accessible after age 18.
Affects:
Military
College Students
Health Care Professionals
Adults in Institutional Settings (nursing home, prison, long
term care facility)

11. Create Data Linkages
• Connect to electronic data sources currently in
the provider’s office, preferably using HL7.
• Connect to local registries and other public• Connect to local registries and other public
health systems (eg TWICES).
• Share data with schools and allow nurses greater
powers to enter data and collect consent.

12. Enable intra-state and inter-state data
sharing
Create financial incentives for full
participation in ImmTrac.participation in ImmTrac.
Ease the burden of data entry by
providing staff support
Provide data in a timely manner
Improve data quality
Provide more support and customer
service

13. Provide additional data elements:
• Tuberculosis test results
• Newborn screening
• Lead screening• Lead screening
• Asthma screening
• Hepatitis B immune globulin doses
• BMI screening
• Vision screening

15. Shared concerns that vaccine financing
and reimbursements will lead to:
• Decrease in access to immunizations
• Increase in use of safety net providers• Increase in use of safety net providers
• Lowered quality and continuity of care

16. Require insurance companies to cover the
full cost of immunizations
Maximize reimbursement through Medicaid
and VFC at the highest level possibleand VFC at the highest level possible
Make Texas a “Universal Purchase” state
Create and promote vaccine purchasing
pools
Increase collaboration among private
physicians and public/private community
health clinics.

17. ‘The Jenny McCarthy Effect’

19. “That
dog
don’t
hunt”

20. Lack of availability of low-cost adult
vaccines
Inability to track exemptions
Border issuesBorder issues
• Access Access Access
• Cross-Border immunizations

21. 1. Immunization Information Systems
• The Future of Immunization Information
Systems
• Update on ImmTrac
• Lifespan Registries• Lifespan Registries
• Cost/benefit of reminder & recall systems
2. Vaccine Financing & Reimbursement
• National Perspective & Scope of Problem
• Texas Perspective
• Practice Habits to ensure financial stability
3. Talking to parents about vaccine safety
4. Advocacy Training

22. O.W.Brown, M.D.,FAAP
Texas Pediatric Society
Diagnostic Clinic of Longview
Mary Derden, RN, BSN
Kelsey-Seybold Clinic
Deborah Durham
St. David’s Community Health Foundation
Anna C. Dragsbaek, J.D.
Houston Area Immunization Partnership
Carrie Kroll
Texas Pediatric Society
Charles T. Leach, M.D.
UTHSCTexas Pediatric Society UTHSC
San Antonio
Jason Sabo
Frontera 501
Laura Sally, MPH
Texas Pediatric Society
Gordon E. Schutze, M.D.
Texas Children's Hospital
Baylor College of Medicine
Jack Sims
Texas Department of State Health Services
Jason V. Terk, M.D.
Cook Children's Physician Network
Adolfo Valadez, M.D., MPH
Texas Department of State Health Services