Deschutes coalition meeting 05 22 12.1

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  • Exclusion summary 2012Children covered by school and children’s facility immunization law:661,099Exclusion Orders:34,868Children excluded:4,618
  • Doctors in our state asked for a clear and concise handout to accompany the VIS. A pediatrician on our workgroup assisted us in creating this. We sent them to every VFC in the state. It’s also available in Spanish on our website—soon to be in Russian.
  • Many of you know about the new CDC provider vaccine conversation tools. We’ve also added AAP videos and training guide.
  • Anecdotes resonate with patients. Read immunization stories about real Oregonians.
  • The open letter has over 200 signatures.
  • The open letter has over 200 signatures.
  • The open letter has over 200 signatures.
  • Our website address is healthoregon.org/imm
  • We’ve placed op-eds and letters to the editor in newspapers. For example, this guest editorial was in the Ashland Tidings for Exclusion Day. It was signed by Dr. Shames, who is on our social marketing workgroup, as well as our medical director Dr. Paul Cieslak
  • We’re working with local health departments in areas with high religious exemption rates to assist them with their own unique vaccine safety social marketing campaigns.
  • When Crook County had a meningococcal outbreak, we were ready to assist with talking points and a press release.
  • We’re working with VAX NW to pilot school information sessions that target schools with high religious exemption rates. We are recruiting parent advocates and VAX NW will train them and provide them with discussion guides. Each school will have a plan that is unique and will speak to that audience.
  • Deschutes coalition meeting 05 22 12.1

    1. 1. Paddling Against the Current:Oregon School Immunization Law and Exemptions Deschutes County Immunization Coalition May 22, 2012
    2. 2. Background
    3. 3. Where are immunizations required? • Public Schools • Private • Preschool Children’s • Child Care Facilities • Head Start • 2 doses of Colleges measles vaccine
    4. 4. What exemptions are allowed? Medical Immunity Religious
    5. 5. What do providers do?
    6. 6. NIS-Teen Adolescent Vaccine Uptake, Ages 13-17 Years 100 90 80 70 US, 2008 60Percent Oregon, 2008 50 US, 2009 40 Oregon, 2009 US, 2010 30 Oregon, 2010 20 10 0 ≥1 Tdap ≥1 MCV4 ≥1 HPV (female) http://www.cdc.gov/vaccines/stats-surv/imz-coverage.htm#nis
    7. 7. Data
    8. 8. Enrollment, Exclusion Letters and Exclusions, 2001-2012700,000600,000500,000400,000300,000200,000100,000 0 Number of exclusions Number of exclusion orders issued Number of children enrolled in schools and childrens facilities
    9. 9. Percent of Children with School/Childrens Facility Required Vaccines, 2012 100 90 80 70 60Percent 50 40 30 20 10 0 DTaP Polio MMR 2nd Hep B Varicella Hep A Hib Tdap Measles Childrens Facility Kindergarten 7th Grade
    10. 10. Percent of Children with Exemptions to School/Childrens Facility Immunization Requirements or No Record, 2012 7 6 5Percent 4 3 2 1 0 Medical Exemptions Religious Exemptions No Record Childrens Facility Kindergarten 7th Grade
    11. 11. Religious Exemption Rates, 2000-2012 7 6% Religious Exempt 5 4 3 2 1 0 Childrens Facility Kindergarten and 1st Grade* 7th Grade
    12. 12. Clatsop Kindergarten and First Grade Religious Exemptions, Validation Surveys 2 facilities Columbia 1 facility resurvey 2 2.7% facilities 1.3% 2 facilities 2000-2001 (Oregon 1.9%) 2007 1 facility 1 school 5 facilities 2 schools 1 school 2.0% 1 school resurvey 1.1% Umatilla Tillamook Hood Wallowa Washington Multnomah River 1.0% 0.2% 2 8.5% schools 1 facility 1.3% none Morrow 1 school Gilliam 0.0% none 1.5% 2 schools Sherman 1 facility 0.0% Union Clackamas none 2 3.5% schools Yamhill 11.7% facility 1.1% Wasco 2 schools 1 facility Polk Marion 1 school 3 schools 2 facilities, 3 schools 1.5% 1.5% 2 schools Baker 1 facility resurvey Wheeler 1 school Lincoln 0.0% 1.7% Jefferson 1 school 1 school resurvey 0.9% 2.8% 1 school 1 facility 3 schools Linn 1.5% Grant Benton 0.8% none 3.6% 1 school Crook 11.5% facility 4 facilities 2 schools 1 school 1 facility resurvey Lane Deschutes 4.2% 1 facility 0.4% Malheur Douglas Harney 1 2.1% facility Coos 1 0.5% facility 5 schools 1.1% 2 schools 21.6% facilities 1 school Lake 1.6% 1 facility 1 school  Janis  <2% Validation Survey Totals  Lorraine  2-4% Facilities—36Curry5.0% Josephine Jackson Klamath 1 facility 0.8%  Peggy  4-6% Schools—42 Facility Resurveys—31 facility 5.2% 1 facility 3 facilities 3.6% 1 school  Stacy  6-8% School Resurveys—2 None  >8% Total Surveys—83
    13. 13. Clatsop Kindergarten and First Grade Religious Exemptions, Validation Surveys 2 facilities Columbia 1 facility resurvey 2 3.8% facilities 1.6% 2 facilities 2001-2002 (Oregon 2.4%) 2007 1 facility 1 school 5 facilities 2 schools 1 school 2.2% 1 school resurvey 1.4% Umatilla Tillamook Hood Wallowa Washington Multnomah River 1.1% 2.0% 2 7.9% schools 1 facility 3.2% none Morrow 1 school Gilliam 0.0% none 2.0% 2 schools Sherman 1 facility 0.0% Union Clackamas none 2 4.7% schools Yamhill 12.7% facility 1.2% Wasco 2 schools 1 facility Polk Marion 1 school 3 schools 2 facilities, 3 schools 1.6% 2.5% 2 schools Baker 1 facility resurvey Wheeler 1 school Lincoln 3.5% 2.1% Jefferson 1 school 1 school resurvey 1.5% 3.5% 1 school 1 facility 3 schools Linn 0.6% Grant Benton 0.8% none 4.2% 1 school Crook 12.8% facility 4 facilities 2 schools 1 school 1 facility resurvey Lane Deschutes 5.0% 1 facility 2.7% Malheur Douglas Harney 1 0.4% facility Coos 1 1.2% facility 5 schools 1.3% 2 schools 21.6% facilities 1 school Lake 0.0% 1 facility 1 school  Janis  <2% Validation Survey Totals  Lorraine  2-4% Facilities—36Curry4.5% Josephine Jackson Klamath 1 facility 0.1%  Peggy  4-6% Schools—42 Facility Resurveys—31 facility 11.2% 1 facility 3 facilities 3.4% 1 school  Stacy  6-8% School Resurveys—2 None  >8% Total Surveys—83
    14. 14. Clatsop Kindergarten and First Grade Religious Exemptions, Validation Surveys 2 facilities Columbia 1 facility resurvey 2 3.5% facilities 2.6% 2 facilities 2002-2003 (Oregon 2.8%) 2007 1 facility 1 school 5 facilities 2 schools 1 school 2.8% 1 school resurvey 1.5% Umatilla Tillamook Hood Wallowa Washington Multnomah River 1.0% 2.0% 2 4.7% schools 1 facility 3.2% none Morrow 1 school Gilliam 0.8% none 2.3% 2 schools Sherman 1 facility 0.0% Union Clackamas none 2 3.1% schools Yamhill 13.1% facility 1.3% Wasco 2 schools 1 facility Polk Marion 1 school 3 schools 2 facilities, 3 schools 1.8% 1.6% 2 schools Baker 1 facility resurvey Wheeler 1 school Lincoln 12.5% 1.9% Jefferson 1 school 1 school resurvey 1.9% 4.4% 1 school 1 facility 3 schools Linn 0.0% Grant Benton 0.9% none 10.2% 1 school Crook 11.2% facility 4 facilities 2 schools 1 school 1 facility resurvey Lane Deschutes 5.8% 1 facility 4.1% Malheur Douglas Harney 1 0.4% facility Coos 1 2.5% facility 5 schools 1.3% 2 schools 21.1% facilities 1 school Lake 0.0% 1 facility 1 school  Janis  <2% Validation Survey Totals  Lorraine  2-4% Facilities—36Curry9.6% Josephine Jackson Klamath 1 facility 1.0%  Peggy  4-6% Schools—42 Facility Resurveys—31 facility 10.8% 1 facility 3 facilities 4.3% 1 school  Stacy  6-8% School Resurveys—2 None  >8% Total Surveys—83
    15. 15. Clatsop Kindergarten Religious Exemptions, Validation Surveys 2 facilities Columbia 1 facility resurvey 2 2.8% facilities 1.5% 2 facilities 2003-2004 (Oregon 2.8%) 2007 1 facility 1 school 5 facilities 2 schools 1 school 3.0% 1 school resurvey 1.6% Umatilla Tillamook Hood Wallowa Washington Multnomah River 1.2% 1.6% 2 1.6% schools 1 facility 4.6% none Morrow 1 school Gilliam 1.8% none 2.4% 2 schools Sherman 1 facility 0.0% Union Clackamas none 2 4.5% schools Yamhill 13.2% facility 1.0% Wasco 2 schools 1 facility Polk Marion 1 school 3 schools 2 facilities, 3 schools 1.7% 2.5% 2 schools Baker 1 facility resurvey Wheeler 1 school Lincoln 6.3% 0.6% Jefferson 1 school 1 school resurvey 2.1% 3.2% 1 school 1 facility 3 schools Linn 1.3% Grant Benton 4.4% none 3.0% 1 school Crook 11.5% facility 4 facilities 2 schools 1 school 1 facility resurvey Lane Deschutes 5.6% 1 facility 4.9% Malheur Douglas Harney 1 2.9% facility Coos 1 3.4% facility 5 schools 0.8% 2 schools 23.4% facilities 1 school Lake 1.3% 1 facility 1 school  Janis  <2% Validation Survey Totals  Lorraine  2-4% Facilities—36Curry7.2% Josephine Jackson Klamath 1 facility 1.0%  Peggy  4-6% Schools—42 Facility Resurveys—31 facility 7.3% 1 facility 3 facilities 4.5% 1 school  Stacy  6-8% School Resurveys—2 None  >8% Total Surveys—83
    16. 16. Clatsop Kindergarten Religious Exemptions, Validation Surveys 2 facilities Columbia 1 facility resurvey 2 3.5% facilities 1.0% 2 facilities 2004-2005 (Oregon 3.4%) 2007 1 facility 1 school 5 facilities 2 schools 1 school 4.2% 1 school resurvey 2.0% Umatilla Tillamook Hood Wallowa Washington Multnomah River 0.7% 1.6% 2 10.5% schools 1 facility 2.6% none Morrow 1 school Gilliam 1.8% none 2.2% 2 schools Sherman 1 facility 0.0% Union Clackamas none 2 7.9% schools Yamhill 13.5% facility 2.7% Wasco 2 schools 1 facility Polk Marion 1 school 3 schools 2 facilities, 3 schools 2.2% 2.8% 2 schools Baker 1 facility resurvey Wheeler 1 school Lincoln 100% 4.3% Jefferson 1 school 1 school resurvey 2.1% 6.0% 1 school 1 facility 3 schools Linn 1.8% Grant Benton 1.2% none 6.5% 1 school Crook 11.3% facility 4 facilities 2 schools 1 school 1 facility resurvey Lane Deschutes 6.2% 1 facility 5.1% Malheur Douglas Harney 1 0.5% facility Coos 1 0.0% facility 5 schools 2.1% 2 schools 23.6% facilities 1 school Lake 1.4% 1 facility 1 school  Janis  <2% Validation Survey Totals  Lorraine  2-4% Facilities—36Curry8.8% Josephine Jackson Klamath 1 facility 1.9%  Peggy  4-6% Schools—42 Facility Resurveys—31 facility 7.7% 1 facility 3 facilities 4.9% 1 school  Stacy  6-8% School Resurveys—2 None  >8% Total Surveys—83
    17. 17. Clatsop Kindergarten Religious Exemptions, Validation Surveys 2 facilities Columbia 1 facility resurvey 2 3.5% facilities 2.3% 2 facilities 2005-2006 (Oregon 3.5%) 2007 1 facility 1 school 5 facilities 2 schools 1 school 4.0% 1 school resurvey 1.6% Umatilla Tillamook Hood Wallowa Washington Multnomah River 1.2% 3.0% 2 7.8% schools 1 facility 6.7% none Morrow 1 school Gilliam 1.6% none 2.2% 2 schools Sherman 1 facility 10.0% Union Clackamas none 2 4.9% schools Yamhill 14.2% facility 3.1% Wasco 2 schools 1 facility Polk Marion 1 school 3 schools 2 facilities, 3 schools 2.0% 3.0% 2 schools Baker 1 facility resurvey Wheeler 1 school Lincoln 18.2% 4.4% Jefferson 1 school 1 school resurvey 3.3% 5.5% 1 school 1 facility 3 schools Linn 2.1% Grant Benton 1.2% none 8.6% 1 school Crook 12.0% facility 4 facilities 2 schools 1 school 1 facility resurvey Lane Deschutes 6.6% 1 facility 6.0% Malheur Douglas Harney 1 0.4% facility Coos 1 1.3% facility 5 schools 2.2% 2 schools 22.4% facilities 1 school Lake 5.8% 1 facility 1 school  Janis  <2% Validation Survey Totals  Lorraine  2-4% Facilities—36Curry6.1% Josephine Jackson Klamath 1 facility 1.7%  Peggy  4-6% Schools—42 Facility Resurveys—31 facility 8.5% 1 facility 3 facilities 5.8% 1 school  Stacy  6-8% School Resurveys—2 None  >8% Total Surveys—83
    18. 18. Clatsop Kindergarten Religious Exemptions, Validation Surveys 2 facilities Columbia 1 facility resurvey 2 4.3% facilities 1.6% 2 facilities 2006-2007 (Oregon 3.6%) 2007 1 facility 1 school 5 facilities 2 schools 1 school 4.7% 1 school resurvey 1.9% Umatilla Tillamook Hood Wallowa Washington Multnomah River 1.4% 3.4% 2 4.8% schools 1 facility 7.0% none Morrow 1 school Gilliam 0.5% none 2.8% 2 schools Sherman 1 facility 6.7% Union Clackamas none 2 4.4% schools Yamhill 14.3% facility 3.1% Wasco 2 schools 1 facility Polk Marion 1 school 3 schools 2 facilities, 3 schools 2.0% 1.6% 2 schools Baker 1 facility resurvey Wheeler 1 school Lincoln 25.0% 5.9% Jefferson 1 school 1 school resurvey 2.3% 4.9% 1 school 1 facility 3 schools Linn 1.9% Grant Benton 3.0% none 3.8% 1 school Crook 12.5% facility 4 facilities 2 schools 1 school 1 facility resurvey Lane Deschutes 5.8% 1 facility 5.7% Malheur Douglas Harney 1 0.0% facility Coos 1 1.3% facility 5 schools 3.1% 2 schools 24.2% facilities 1 school Lake 1.2% 1 facility 1 school  Janis  <2% Validation Survey Totals  Lorraine  2-4% Facilities—36Curry3.9% Josephine Jackson Klamath 1 facility 1.3%  Peggy  4-6% Schools—42 Facility Resurveys—31 facility 8.1% 1 facility 3 facilities 6.1% 1 school  Stacy  6-8% School Resurveys—2 None  >8% Total Surveys—83
    19. 19. Clatsop Kindergarten Religious Exemptions, Validation Surveys 2 facilities Columbia 1 facility resurvey 2 5.6% facilities 1.0% 2 facilities 2007-2008 (Oregon 3.9%) 2007 1 facility 1 school 5 facilities 2 schools 1 school 5.2% 1 school resurvey 1.9% Umatilla Tillamook Hood Wallowa Washington Multnomah River 1.5% 4.0% 2 9.0% schools 1 facility 4.3% none Morrow 1 school Gilliam 0.5% none 2.2% 2 schools Sherman 1 facility 0.0% Union Clackamas none 2 7.2% schools Yamhill 14.9% facility 3.2% Wasco 2 schools 1 facility Polk Marion 1 school 3 schools 2 facilities, 3 schools 2.2% 2.3% 2 schools Baker 1 facility resurvey Wheeler 1 school Lincoln 6.7% 7.6% Jefferson 1 school 1 school resurvey 1.7% 1 school 1 facility 5.8% 3 schools Linn 2.0% Grant Benton 3.6% none 8.5% 1 school Crook 11.5% facility 4 facilities 2 schools 1 school 1 facility resurvey Lane Deschutes 5.3% 1 facility 6.6% Malheur Douglas Harney 1 1.2% facility Coos 1 1.6% facility 5 schools 2.6% 2 schools 23.2% facilities 1 school Lake 1.3% 1 facility 1 school  Janis  <2% Validation Survey Totals  Lorraine  2-4% Facilities—36Curry1.3% Josephine Jackson Klamath 1 facility 1.6%  Peggy  4-6% Schools—42 Facility Resurveys—31 facility 8.7% 1 facility 3 facilities 6.4% 1 school  Stacy  6-8% School Resurveys—2 None  >8% Total Surveys—83
    20. 20. Clatsop Kindergarten Religious Exemptions, Validation Surveys 2 facilities Columbia 1 facility resurvey 2 6.2% facilities 1.8% 2 facilities 2008-2009 (Oregon 4.9%) 2007 1 facility 1 school 5 facilities 2 schools 1 school 6.3% 1 school resurvey 2.9% Umatilla Tillamook Hood Wallowa Washington Multnomah River 2.0% 4.2% 2 14.3% schools 1 facility 8.9% none Morrow 1 school Gilliam 1.0% none 3.1% 2 schools Sherman 1 facility 0.0% Union Clackamas none 2 5.8% schools Yamhill 15.8% facility 5.9% Wasco 2 schools 1 facility Polk Marion 1 school 3 schools 2 facilities, 3 schools 3.3% 3.7% 2 schools Baker 1 facility resurvey Wheeler 1 school Lincoln 0.0% 5.7% Jefferson 1 school 1 school resurvey 3.4% 1 school 1 facility 6.1% 3 schools Linn 0.4% Grant Benton 5.1% none 2.2% 1 school Crook 13.2% facility 4 facilities 2 schools 1 school 1 facility resurvey Lane Deschutes 7.6% 1 facility 7.4% Malheur Douglas Harney 1 0.8% facility Coos 1 3.8% facility 5 schools 3.8% 2 schools 24.8% facilities 1 school Lake 1.4% 1 facility 1 school  Janis  <2% Validation Survey Totals  Lorraine  2-4% Facilities—36Curry4.4% Josephine Jackson Klamath 1 facility 1.6%  Peggy  4-6% Schools—42 Facility Resurveys—31 facility 10.9% 1 facility 3 facilities 5.1% 1 school  Stacy  6-8% School Resurveys—2 None  >8% Total Surveys—83
    21. 21. Clatsop Kindergarten Religious Exemptions, Validation Surveys 2 facilities Columbia 1 facility resurvey 2 6.1% facilities 3.4% 2 facilities 2009-2010 (Oregon 5.2%) 2007 1 facility 1 school 5 facilities 2 schools 1 school 6.8% 1 school resurvey 3.4% Umatilla Tillamook Hood Wallowa Washington Multnomah River 1.4% 5.0% 2 10.3% schools 1 facility 5.7% none ←1.9%→ Morrow 1 school Gilliam 1.0% none 3.3% 2 schools Sherman 1 facility Union Clackamas none 2 6.2% schools Yamhill 15.6% facility Wasco 2 schools 1 facility Polk Marion 1 school 3 schools 2 facilities, 3 schools 3.6% 3.5% 2 schools Baker 1 facility resurvey Wheeler 1 school Lincoln 0.0% 4.0% Jefferson 1 school 1 school resurvey 2.0% 1 school 1 facility 7.3% 3 schools Linn 1.4% Grant Benton 4.1% none 1.8% 1 school Crook 13.6% facility 4 facilities 2 schools 1 school 1 facility resurvey Lane Deschutes 7.8% 1 facility 9.5% Malheur Douglas Harney 1 0.6% facility Coos 1 3.0% facility 5 schools 3.8% 2 schools 26.6% facilities 1 school Lake 4.5% 1 facility 1 school  Janis  <2% Validation Survey Totals  Lorraine Facilities—36  2-4%Curry5.9% Josephine Jackson Klamath 1 facility 3.1%  Peggy Schools—42  4-6% Facility Resurveys—31 facility 9.3% 1 facility 3 facilities 6.0% 1 school  Stacy  6-8% School Resurveys—2 None  Total Surveys—83>8%

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