T he New Jersey Department of Health Vaccine Preventable Disease Program (VPDP) recently received the 2015 Centers for Disease Control and Prevention (CDC) Childhood Influenza Immunization Coverage Award. This award is in recognition of New Jersey’s success in achieving 64.3 percent influenza vaccination rate during the 2014-2015 season among children six months through 17 years of age, based on Healthy People 2020 targets. This is the second year the VPDP received this award. Nationally, 59.3 percent of children in this age group were vaccinated. The Healthy People objective for this age group is 70 percent. The VPDP staff attributes the high influenza coverage rates to their implementation of evidence-based strategies and collaboration with public health and community partners. The implementation of school immunization mandates has shown to be an effective method for increasing vaccination rates. In 2008, New Jersey set a precedent by being the first state to require flu vaccination for children six months through four years of age attending licensed child care/preschool. Connecticut and Rhode Island followed NJ’s lead by adopting similar requirements. According to the 2014-2015 National Winter 2016 Communicable Disease Service Mission Statement Our mission is to prevent communicable disease among all citizens of New Jersey, and to promote the knowledge and use of healthy lifestyles to maximize the health and well-being of New Jerseyans. We will accomplish our mission through our leadership, collaborative partnerships, and advocacy for communicable disease surveillance, research, education, treatment, prevention and control. Chris Christie, Governor Kim Guadagno, Lt. Governor Cathleen D. Bennett Acting Commissioner COMMUNICABLE DISEASE SERVICE Christina Tan, MD, MPH State Epidemiologist/ Assistant Commissioner Gary Ludwig, MS, Director Suzanne Miro, MPH, MCHES Editor, Research Scientist Continued on page 6 C2263 Vaccine Preventable Disease Program Receives Recognition from the Centers for Disease Control and Prevention New Jersey Department of Health Vaccine Preventable Disease Program staff
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The NJDOH CommunicableDisease Service includes:Infectious and Zoonotic Disease Program (IZDP): 609-826-5964
Vaccine Preventable Disease Program (VPDP): 609-826-4860
We’re on the Web!www.nj.gov/health/cd
Past issues of the New Jersey Com-muni-CABLE are available online at:http://nj.gov/health/cd/pub.shtml.
Continued from/on page x
The New Jersey Departmentof Health VaccinePreventable Disease
Program (VPDP) recently receivedthe 2015 Centers for DiseaseControl and Prevention (CDC)Childhood InfluenzaImmunization Coverage Award.This award is in recognition ofNew Jersey’s success in achieving64.3 percent influenza vaccinationrate during the 2014-2015 seasonamong children six monthsthrough 17 years of age, based onHealthy People 2020 targets. Thisis the second year the VPDPreceived this award. Nationally,59.3 percent of children in this agegroup were vaccinated. TheHealthy People objective for thisage group is 70 percent.
The VPDP staff attributes the highinfluenza coverage rates to theirimplementation of evidence-basedstrategies and collaboration withpublic health and communitypartners. The implementation ofschool immunization mandateshas shown to be an effectivemethod for increasing vaccinationrates. In 2008, New Jersey set aprecedent by being the first stateto require flu vaccination forchildren six months through fouryears of age attending licensedchild care/preschool. Connecticutand Rhode Island followed NJ’slead by adopting similarrequirements. According to the2014-2015 National
Winter 2016
Communicable DiseaseService Mission StatementOur mission is to prevent communicable disease amongall citizens of New Jersey, andto promote the knowledge anduse of healthy lifestyles to maximize the health and well-being of New Jerseyans.
We will accomplish our mission through our leadership,collaborative partnerships, andadvocacy for communicable disease surveillance, research,education, treatment, prevention and control.
Suzanne Miro, MPH, MCHESEditor, Research Scientist
Continued on page 6
C2263
Vaccine Preventable Disease ProgramReceives Recognition from the Centers for Disease Control andPrevention
New Jersey Department of Health Vaccine Preventable Disease Program staff
Winter 2016
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Proper vaccineadministration is a criticalcomponent of a successful
immunization program.Appropriate vaccine preparation,site and route selection, needlelength, and injection techniquesare essential to the correctadministration of vaccines.Improperly administered injectionsmay result in injuries or preventvaccines from providing optimalprotection. All personnel whoadminister vaccines should receivecomprehensive, competency-basedtraining regarding vaccineadministration policies andprocedures before administeringvaccines. Staff should receiveongoing education, such aswhenever vaccine administrationrecommendations are updated, orwhen new vaccines are added tothe facility’s inventory, to maintainstaff competency.
The foundation of medicationadministration is application of the“Rights of MedicationAdministration.” These rightsshould be applied to eachencounter when vaccines areadministered. These rights includethe following:
Right patient:Providers should use everyopportunity to assess a patient’simmunization status and
administer the necessaryage-appropriate vaccines. Allpatients should be screened forcontraindications and precautionsprior to administering any vaccine,even if the patient has previouslyreceived that vaccine. The patient’sstatus may change from one visit tothe next or recommendationsregarding contraindications andprecautions may have changed.Screening for contraindications andprecautions can prevent adverseevents following vaccination.
Right vaccine and diluent (whenapplicable):In order to avoid using the wrongvaccine, do not store vaccines withsimilar names or abbreviations, oroverlapping component(s) (e.g.,DTaP, DT, Tdap, Td) immediatelynext to each other. Check thevaccine label three times; when youremove the vaccine from storage,when you draw it up, and when youdispose of the syringe or place thevial back into storage.
Vaccines should be reconstitutedaccording to manufacturerguidelines using only the specificdiluent supplied by the manufacturerfor that vaccine. If the wrong diluentis used, the vaccine dose is not validand will need to be repeated usingthe correct diluent.
Know Your “Rights” of VaccineAdministration
Continued on page 5
The NJDOH CommunicableDisease Service includes:Infectious and Zoonotic Disease Program (IZDP): 609-826-5964
Regional Epidemiology Program (REP): 609-826-5964
Vaccine Preventable Disease Program (VPDP): 609-826-4860
We’re on the Web!www.nj.gov/health/cd
Past issues of the New JerseyCommuni-CABLE are available online at:http://nj.gov/health/cd/pub.shtml.
The NJDOH CommunicableDisease Service includes:Infectious and Zoonotic Disease Program (IZDP): 609-826-5964
Regional Epidemiology Program (REP): 609-826-5964
Vaccine Preventable Disease Program (VPDP): 609-826-4860
We’re on the Web!www.nj.gov/health/cd
Past issues of the New JerseyCommuni-CABLE are available online at:http://nj.gov/health/cd/pub.shtml.
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Jason Mehr, MPH, New JerseyDepartment of Health(NJDOH) Healthcare Associated Infections (HAI)
Coordinator and LindsayHamilton, MPH, Council of Stateand Territorial EpidemiologistsHAI Fellow, provided a training tothe Long Term Care Surveyors onNovember 10 about theaward-winning “NJDOH ReportingTool.” Developing the tool was acollaborative effort between theCommunicable Disease Service andHealth Facilities, Licensing andField Operations staff. Thepurpose of the tool is to formalizethe reporting of infection controlbreaches between surveyors anddisease investigators. There are twocategories of breaches: Category Aand Category B. Category Abreaches include likelihood ofblood exposure as a result of thebreach, such as reusing needles orsyringes for more than oneindividual, reusing a needle orsyringe which has already beenused to administer medication to an
individual, subsequently enteredinto a medication vial, and thenusing contents for anotherindividual, and using alancing/finger stick device for morethan one individual. Thesebreaches have been identified asvehicles to transmit blood-bornepathogens, such as hepatitis B,hepatitis C and HIV. Category Bbreaches are tailored to thesettings, such as long-term careand acute care, and are infectioncontrol breaches that may lead todisease transmission. These mayinclude incorrect reprocessing ofinstruments, reuse of biopsyneedles that were intended forsingle use and/or lack of personalprotective equipment duringwound care. The training includedan informative presentation andinteractive case studies. Acute caresurveyors were trained in 2014.New Jersey’s reporting tool wasrecognized by the Association ofHealth Facility Survey Agencies attheir 2015 Conference.
New Jersey Health Reporting Tool
On December 1, 2015, theVaccine PreventableDisease Program held a
webinar for health educators,public health nurses and otherpublic health professionals tointroduce a new flu educationresource. The community flueducation toolkit was developedfor public health professionals to
provide education to residents intheir communities about fluprevention, the benefits of gettinga flu shot, and the 2015-2016 fluvaccine. Webinar participantsreceived slides, interactivepre/post-tests and other flumaterials. For more informationcontact Jennifer Smith [email protected].
The NJDOH CommunicableDisease Service includes:Infectious and Zoonotic Disease Program (IZDP): 609-826-5964
Regional Epidemiology Program (REP): 609-826-5964
Vaccine Preventable Disease Program (VPDP): 609-826-4860
We’re on the Web!www.nj.gov/health/cd
Past issues of the New JerseyCommuni-CABLE are available online at:http://nj.gov/health/cd/pub.shtml.
The New Jersey Hepatitis BCoalition held their firstconference on December 9,
2015 at the NJ HospitalAssociation. Dr. Christina Tan, MD,MPH provided the keynoteaddress.Presentations bycoalition
partners and links to valuablecommunity resources, includingscreening and linkage to care, wereshared.
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Hepatitis B Conference
NJDOH hosted a daylongsocial media conferenceon December 7, 2015.
More than 75 health educators,public health nurses andcommunication professionals fromacross the state attended. Thisconference featured variousspeakers from federal, state andlocal partners and examined howthey use social media to engage thecommunity. The morning sessionsincluded best practices, developingpolicies and lessons learned aboutusing social media platforms ingovernment and health care
settings. The highlight was anafternoon Twitter exercise.Participants were given multiplescenarios and then asked todevelop hashtags and tweets fortheir agency based on the topic.The tweets were then evaluated bythe facilitators. Also discussed washow to incorporate public healthmessages that include riskcommunication into 140characters.
Social Media Conference
Follow us on Twitter at twitter.com/NJDeptofhealth
The NJDOH CommunicableDisease Service includes:Infectious and Zoonotic Disease Program (IZDP): 609-826-5964
Regional Epidemiology Program (REP): 609-826-5964
Vaccine Preventable Disease Program (VPDP): 609-826-4860
We’re on the Web!www.nj.gov/health/cd
Past issues of the New JerseyCommuni-CABLE are available online at:http://nj.gov/health/cd/pub.shtml.
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Know Your Rights, continued from page 2
Right time (including the correctage and interval, as well asbefore the product expirationtime/date):Providers should make sure allvaccines are administered at theappropriate age and dose-spacingintervals. If a dose wasinadvertently given at too young anage or at less than the minimuminterval, the dose is not consideredvalid and must be repeated. Therepeat dose should be spaced afterthe invalid dose by an interval atleast equal to the recommendedminimum interval. Adhering tominimum ages and intervals is vitalto making certain your patientsreceive vaccines on a schedule thatensures vaccine effectiveness.
Each vaccine and diluent vialshould be carefully inspected fordamage or contamination prior touse. The expiration date printed onthe vial or box should be checked.Regardless of expiration date,vaccine and diluent should only beused as long as they are normal inappearance and have been storedand handled properly. Expiredvaccine or diluent should never beused.
Right dosage:Vaccine dosages may varydepending on the age of thepatient and the particular vaccineproduct. Be sure to verify thedosage is correct prior to giving thevaccine to your patient. The entirecontents of single dose vials should
be drawn up and administered.Never administer the contents of asingle-dose vial of vaccine to morethan one patient. Never “pool” thecontents of more than one vial forone vaccine dose.
Right route and Right site:There are five routes(intramuscular, subcutaneous,intradermal, nasal, or oral) used toadminister vaccines. The route,site, and needle size varydepending on the age and weight ofthe patient and type of vaccine. Forspecific information, please visithttp://www.immunize.org/catg.d/p3085.pdf
Deviation from the recommendedroute may reduce vaccine efficacy orincrease local adverse reactions.Vaccines administered by the wrongroute or with the wrong size needlemay need to be repeated.
Right documentation:Accurate documentation can helpprevent administration errors andcurtail the number and costs ofexcess vaccine doses administered.All vaccines administered should befully documented in the patient’spermanent medical record.Healthcare providers whoadminister vaccines covered by theNational Childhood Vaccine InjuryAct are required to ensure that thepermanent medical record of therecipient indicates:v Date of administrationv Vaccine manufacturerv Vaccine lot numberv Name and title of the person
Get more information athttp://nj.gov/health/cd/handwashing.shtml.
The NJDOH CommunicableDisease Service includes:Infectious and Zoonotic Disease Program (IZDP): 609-826-5964
Regional Epidemiology Program (REP): 609-826-5964
Vaccine Preventable Disease Program (VPDP): 609-826-4860
We’re on the Web!www.nj.gov/health/cd
Past issues of the New JerseyCommuni-CABLE are available online at:http://nj.gov/health/cd/pub.shtml.
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Immunization Survey-Flu, 79.1percent of children aged sixmonths through four years in NJare vaccinated, which surpasses thenational average (70.4 %); NJ isranked the fifth highest state for flucoverage in the six months throughfour years age category.
In order to enhance access, the NJVaccine for Children (VFC)Program provides allrecommended immunizations(including influenza) for childrenfrom birth through 18 years of agewho are Medicaid eligible,uninsured, or American Indian orAlaska Native. Additionally, theVPDP identifies areas with lowsocioeconomic status and promoteslocations (local healthdepartments, federally qualifiedhealthcare centers) to access free orlow-cost vaccines for childrenthrough the distribution ofbookmarks available in variouslanguages.
The VPDP has developed aninnovative campaign to raiseawareness of influenza and othervaccines recommended foradolescents. In collaboration withthe Partnership for Maternal and
Child Health of Northern NewJersey, the VPDP runs “Protect MeWith 3+” a social media campaign,annual youth video contest, andeducational website(http://www.protectmewith3.com/)to promote vaccination againsttetanus, diphtheria, pertussis(Tdap), meningococcal, humanpapillomavirus (HPV), andinfluenza among New Jersey youthand their parents. The VPDPreceived the Association ofImmunization Managers (AIM)2015 Bull’s-Eye Award inrecognition of “Protect Me with3+” as an outstandingimmunization initiative.
Through the use of educationalresources, presentations, andcollaboration with health servicegrantees, the VPDP regularlypromotes flu vaccination todifferent audiences such aschildcare/preschool directors,school nurses, healthcare providers,maternal/child health consortia,parents, and community members.Along with these and futureinitiatives, the VPDP will continueto improve and sustain influenzaimmunization coverage across allage groups.
The NJDOH CommunicableDisease Service includes:Infectious and Zoonotic Disease Program (IZDP): 609-826-5964
Regional Epidemiology Program (REP): 609-826-5964
Vaccine Preventable Disease Program (VPDP): 609-826-4860
We’re on the Web!www.nj.gov/health/cd
Past issues of the New JerseyCommuni-CABLE are available online at:http://nj.gov/health/cd/pub.shtml.
who administered the vaccineand the address of the facilitywhere the permanent record willreside
v Vaccine Information Statement(VIS) l date printed on the VISl date VIS given to patient or
parent/guardian
Many recordkeeping tasks, as wellas patient reminder/ recallactivities, can be greatly simplifiedby participation in the statewideregistry, New Jersey ImmunizationInformation System (NJIIS). NJIISmaintains immunization data onNew Jersey residents, andconsolidates immunizationinformation reported from multipleproviders into individual patientrecords to help ensure providershave accurate information forclinical decision support.
All health care practitioners whoimmunize children less than sevenyears of age are required to enrollas an authorized user of NJIIS andreport vaccinations to NJIIS(N.J.A.C. 8:57-3.16). For moreinformation about enrolling as anew site or user, visit NJIIS onlineat https://njiis.nj.gov and click“NJIIS Training Opportunities” andcontact the Maternal and ChildHealth Consortium RegionalTrainer in your county.
In addition to the “Rights ofVaccine Administration,” healthcareproviders should follow appropriateprecautions to minimize the risks of
spreading disease during theadministration of vaccines.
v Hand hygieneHand hygiene is critical toprevent the spread of illnessand disease. Hand hygieneshould be performed beforevaccine preparation, betweenpatients, and any time handsbecome soiled, e.g., diaperingor cleansing excreta. Handsshould be cleansed with awaterless alcohol-based handrub or, washed thoroughly withsoap and water when hands arevisibly dirty or contaminatedwith blood or other body fluids.
v Gloves Occupational Safety and HealthAdministration (OSHA)regulations do not requiregloves to be worn whenadministering vaccines unlessthe person administering thevaccine is likely to come intocontact with potentiallyinfectious body fluids or hasopen lesions on the hands. Ifgloves are worn, they should bechanged and hand hygieneperformed between patients.
v EquipmentA separate needle and syringeshould be used for eachinjection. Never administermedications from the samesyringe to more than onepatient, even if the needle ischanged. Immediately afteruse, all used syringe/needle
The NJDOH CommunicableDisease Service includes:Infectious and Zoonotic Disease Program (IZDP): 609-826-5964
Regional Epidemiology Program (REP): 609-826-5964
Vaccine Preventable Disease Program (VPDP): 609-826-4860
We’re on the Web!www.nj.gov/health/cd
Past issues of the New JerseyCommuni-CABLE are available online at:http://nj.gov/health/cd/pub.shtml.
Kara McGinnis Pilote joins the Infectiousand Zoonotic Disease Program as aTemporary Epidemiology FieldAssignee (TEFA) from CDC's Office ofPublic Health Preparedness andResponse. She is a graduate of theUniversity of South Florida and TheGeorge Washington University, andmost recently has worked with the CDCas a Prevention Specialist in the NYCBureau of TB Control.
Ma'isah Burks joins the RegionalEpidemiology Program as the CDCCareer Epidemiology Field Officer.She is a graduate of University ofLouisville and has worked with theKentucky Department of Public Health
and Louisville Metro Department ofPublic Health and Wellness inLouisville, KY as a RegionalEpidemiologist coveringcommunicable disease, policy planningand development, and emergencypreparedness over the last seven years.
Jessica Felix joins the Infectious andZoonotic Disease Program as anInfection Control Specialist on theHealthcare Associated Infection Team.She is a Registered Nurse, graduate ofWilmington University, and has workedwith Buttonwood Behavioral HealthHospital as an Occupational Healthand Infection Prevention Nurse.
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CDS Welcomes New Staff!
devices should be placed inbiohazard containers that areclosable, puncture-resistant,leakproof on sides and bottomand labeled or color-coded. Thispractice helps prevent accidentalneedlesticks and reuse. Usedneedles should not be recapped,cut, or detached from thesyringes before disposal. Emptyor expired vaccine vials areconsidered medical waste andshould be disposed of accordingto state regulations. Moreinformation can be found atOSHA’s website.
The NJDOH CommunicableDisease Service includes:Infectious and Zoonotic Disease Program (IZDP): 609-826-5964
Regional Epidemiology Program (REP): 609-826-5964
Vaccine Preventable Disease Program (VPDP): 609-826-4860
We’re on the Web!www.nj.gov/health/cd
Past issues of the New JerseyCommuni-CABLE are available online at:http://nj.gov/health/cd/pub.shtml.
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Disease ReportingMagnetsH Do you have the latest version of the
NJDOH Reportable Disease magnet?The latest version is gold and lists allof the reportable and immediatelyreportable diseases. If you need amagnet, please contact your regionalepidemiologist at 609-826-5964!!
