+
Prevention Plan: Hepatitis A VaccinationJenni StracenerUniversity of Alabama: NUR 735
2+Introduction to the Prevention Plan Hepatitis A vaccine Focusing on Adolescents
Overall Goal: Implement the requirement of the Hepatitis A vaccine
for 7th grade entry in the state of Tennessee
3+Health Risk of Hepatitis A Hepatitis A Virus
Fecal/Oral transmission 14-50 day incubation period
Symptoms Fatigue, vomiting, diarrhea, headaches, myalgia Dark Urine, clay colored stools, jaundice
Vaccine: Vaqta and Havrix most effective way of preventing the spread of disease
Clinical Outcome Symptoms more prominent in children >6, adolescents and adult
(Craig and Schaffner, 2004; Karali, Basaranoglu, Karali, Oral, & Killic, 2011; Matheny & Kingery, 2012; WHO, 2013)
4+Health Risk of Hepatitis A
5+Hepatitis A in Adolescents Low Vaccination Rates (Dorell, Yankey, Byrd, &
Murphy, 2012; Sakou, et. al., 2011) 42-60% started the series 70% completion rate
Rates higher in states with Vaccination requirements (Dorell, Yankey, Byrd, & Murphy, 2012)
Tennessee (Dorell, Yankey, Byrd, & Murphy, 2012) 34.6% rate in adolescents 14+, with 64.3% completion
Lack of Education (Gowda, Schaffer, Dombkowski, & Dempsey, 2010) Both parental and medical staff
6+History and Current Recommendations 1996 (Dorell, Yankey, Byrd, & Murphy, 2012; Klevens, et. al., 2011)
Recommended for age> 2 in high risk communities
1999 (Dorell, Yankey, Byrd, & Murphy, 2012; Klevens, et. al., 2011) Recommended for increase number of states recommending vaccination
2006 (Dorell, Yankey, Byrd, & Murphy, 2012; Klevens, et. al., 2011) Vaccination of ALL children at 12 months of age Maintain existing programs for children 2 to 18 years of age Areas without existing programs could consider vaccination for
unvaccinated children 2 to 18 years of age Recommended for any person wishing to obtain immunity
Still remains lower than other recommended vaccines (Byrd, Santibanez, & Chaves, 2011)
7+Primary Prevention Hepatitis A Vaccination
ProtectsPromotesPrevents
8+Primary Prevention
(CDC, 2013)
9+Interdisciplinary Plan Propose new recommendation Approval for implementation from Tennessee Department
of Health Lobby for revision of Immunization Laws Collaboration with Tennessee Department of Education for
timeline Collaboration with Pharmaceutical Companies for supplies Education of Health Care Professionals on new laws Implementation
10+Prevention Plan Timeline
Proposal • Fall, 2014
Law Reform
• Spring, 2015
Collaboration• 2015
-2016
Implementation
• Fall, 2017
11+
Disciplines Involved Epidemiology Education Nursing Medicine Politics
12+Epidemiology
Discussed importance of vaccination Explain the nature of the Hepatitis A Virus Explain transmission of disease
13+Nursing and Medicine UTD with recommendations (CDC, 2013)
ACIP and State Laws
Review vaccine records of adolescents (Lai, Faye, & Bocchini, 2011)
Educate families; Recommend Vaccine (Gowda, Schaffer, Dombkowski, & Dempsey, 2010; Dorell, Yankey, Byrd, & Murphy, 2012; Raczniak, et. al, 2013)
Lobby for coverage and reimbursement (Dorell, Yankey, Byrd, & Murphy, 2012; Singer, Davis, Gebremariam, & Clark, 2012)
14+Education School Administrators
Agree to and collaborate on new laws Educate employees
School Nurses Enforces School Entry Laws Review Vaccine Records
15+Policy Makers
VFC Program (Dorell, Yankey, Byrd, & Murphy, 2012)
Insurance Coverage (Singer, Davis,, Gebremariam, & Clark, 2012)
State Laws
+
EmpowermentDecision Making
Delegation
LeadershipCompetencie
s
+ 17
Empowerment
ScheduleSide EffectsVaccine
Information
Informed and Accurate Decisions
Prevention Plan: Hepatitis A
KnowledgeSkillsResources
+ 18
Delegation
Talents Skills Strengths Coordination
School Nurses Administrators Policy Makers Medical
Professionals
Develops and Contributes
Prevention Plan: Hepatitis A
+ 19
Decision Making
When Where How much
Costs Protocols Meeting with
interdisciplinary team
Implementation
Input from Others Prevention Plan: Hepatitis A
20+Evaluating the Intervention
Baseline rates Hepatitis A diagnosis in TNImmunization rates in 7th graders
Follow upDecline in diagnosis?
21+Summary Increase immunization rates of Hepatitis A
(Heo, et al, 2013) Prevent viral Hepatitis A Prevent spread of the disease Involves Interdisciplinary Approach Requires Leadership
22+ReferencesByrd, K. K., Santibanez, T. A., & Chaves, S. S. (2011). Predictors of Hepatitis
A Vaccination Among Young Children in the United States. Vaccine, 17(12), 3254-3259.
Craig, A. S. & Schaffner, W. (2004). Prevention of Hepatits A with the Hepatitis A Vaccine. New England Journal of Medicine, 305, 476-481. DOI: 10.1056/NEJMcp031540
CDC. (2013). Hepatitis A Vaccination. Retrieved from http://www.cdc.gov/Vaccines/vpd-vac/hepa/default.htm
Dorell, C. G., Yankey, D., Byrd, K. K., & Murphy, T. V. (2012). Hepatitis A Vaccination Coverage Among Adolescents in the United States. Pediatrics, 129(2): 213-221. doi: 10.1542/peds.2011-2197
Gowda, C., Schaffer, S. E., Dombkowski, K. J., & Dempsey, A. F. (2012). Understanding Attitudes Toward Adolescent Vaccination and the Decision-making Dynamic Among Adolescents, Parents Heo, J. Y., Song, J. Y., Noh, J. Y., Seo, Y. B., Kim ,I. S., Choi, W. S., Kim, W. J., Cho, G. J., Hwang, T. G., & Cheong, H. J. (2013). Low Level of Immunity Against Hepatitis A Among Korean adolescents: Vaccination rate and related factors. American Journal of Infection Control, 41(10), e97-e100.
Karali, Z., Basaranoglu, S. T., Karali, Y., Oral, B., & Killic, S. S. (2011). Autoimmunity and Hepatits A Vaccine in Children. Journal of Investigational Allergology and Clinical Immunology, 21(5): 389-393.
Klevens, R. M., Moran, D. K., Wasley, A., Gallagher, K., McQuillan, G. M.. Kuhnert, W., Teshale, E. H., Drobeniuc, J., & Bell, P.B. (2011). Seroprevalance of Hepatitis A Virus Antibodies in the I. S.: Results from the National Health and Nutrition examination survey. Public Health Reports, 126(4): 522-532.
23+ReferencesLai, J., Faye, K. E., & Bocchini, J. A. (2011). Update on Childhood and
Adolescent Immunizations: Selected review of US recommendations and literature: Part 2. Current Opinions in Pediatrics, 4, 470-481. doi: 10.1097/MOP.0b013e3283488160.
Matheny, S. C. & Kingery, J. E. (2012). Hepatitis A. American Family Physician, 86(11): 1027-1034.
Raczniah, G. A., Thomas, T. K., Bulkow, L. R., Negus, S. E., Zanis, C. L., Bruce, M. G., Spradling, P. R., Teshale, E. H., & McMahon, B. J. (2013). Duration of Protection against Hepatitis A for the Current Two-dose Vaccine Compared to a Three-dose Vaccine Schedule in Children. Vaccine, 31(17), 2152-2155. http://dx.doi.org/10.1016/j.vaccine.2013.02.048
Sakou, I., Tsitsika, A. K., Papaevangelou, V., Tzavela, E. C., Greydanus, D. E., & Tsolia, M. N. (2011). Vaccination Coverage Among Adolescents and Risk Factors Associated with Incomplete Immunization. Euopean Journal of Pediatrics, 170 (11) ,1419-1426.
Sartori, A. M., de Soarez, P. C., Novaes, H. M., Amaku, M., de Azevedo, R. S., Mareira, R. C., Pereira, L. M., Ximenes, R. A., &Martelli, C. M. (2012). Cost-Effectiveness Analysis of Universal Childhood Hepatitis A Vaccination on Brazil: Regional analyses according to the endemic context. Vaccine, 30(52), 7489-7497. http://dx.doi.org/10.1016/j.vaccine.2012.10.056
Singer, D. C., Davis, M. M., Gebremariam, A., & Clark, S. J. (2012). Underinsurance for Recently Recommended Vaccines in Private Health Plans. Jounral of Community Health, 37(6), 1164-1167.
World Health Organization. (2012). WHO Position Paper on Hepatitis A Vaccines – June 2012. Weekly Epidemiological Record, 87, 261-276