Secretary John Wiesman, DrPH, MPH

STATE OF THE STATE: WASHINGTON IMMUNIZATION UPDATE

Washington State Department of Health | 3

Update on immunization rates for Washington

Outbreaks

Call to Action – address misinformation and create a pro-immunization culture

Q&A

Overview

IMMUNIZATION RATES

Washington State Department of Health | 5

Compare state and national averages

Best for childhood and adolescent immunization rates

Better for adult and flu immunization rates

Data Sources

Washington State Department of Health | 6

Data Resources

o IIS County and ACH Level Coverage: https://www.doh.wa.gov/DataandStatisticalReports/HealthDataVisualization/ImmunizationDataDashboards

o School Immunization Status (kindergarten, 6th grade, K-12): https://www.doh.wa.gov/DataandStatisticalReports/HealthDataVisualization/SchoolImmunization

o NIS Childhood: https://www.cdc.gov/vaccines/imz-managers/coverage/childvaxview/index.html

o NIS Teen: https://www.cdc.gov/vaccines/imz-managers/coverage/teenvaxview/index.html

Washington State Department of Health | 7

WA IIS Immunization Coverage

Among 19-35 month olds, WA 2018

59%

HP 2020 goal: 80% complete series

HP 2020 goal: 90% each vaccine on time

Washington State Department of Health | 8

WA IIS Immunization Coverage

Among 19-35 month olds by County, WA 2018

Adams: 72%

Asotin: 19%

Washington State Department of Health | 9

HPV Missed Opportunities

o 21.1% of adolescents 11-12 years old received Tdap or MCV, but no HPV

MEASLES OUTBREAKS

Beginning of the Outbreak

January 2019 February 2019 March 2019

Dec 31, 2018First known case visits Memorial Urgent Care

Jan 4, 2019Lab confirms measles in a child 1–10 years old with unknown immunization history

Jan 15, 2019

2 additional confirmed cases and 11 suspect cases identified.

Public Health activates Incident Command System to respond to the outbreak.

Washington State Department of Health | 13

Tested 586 Samples | Jan – May 14: 533 Tests

Summary: 71 Cases

41

30

Lab Confirmed

Epi-linked

0 10 20 30 40 50

Confirmation Type

61

7

3

Unvaccinated

Unverified

One MMR

0 10 20 30 40 50 60 70

Vaccination Status

52

14

14

0

10

20

30

40

50

60

1-10Years

11-18Years

19-29Years

30-39Years

Age Range

71 Cases in Time

Measles cases, by transmission setting and date of rash onset:Clark County, WA 12/30/2018 – 3/13/2019

Washington State Department of Health | 16

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Date of Rash Onset

Airport, WA Resident Airport, Out-of-State Resident Non-Airport Public Setting Household Unknown

Measles Cases by Exposure Setting (n=16)

21-day incubation period

Common exposure date at SeaTac Airport

21-day incubation period

Sea-Tac Outbreak

April 2019 May 2019 June 2019

April 25, 2019Unknown person with measles at Sea-Tac International airport

May 9-14, 2019Measles rash begins in 7 exposed at airport

June 23, 2019

Unexpected case found –genetically identical virus

Washington State Department of Health | 18

Tested 586 Samples | May 14 – 24: 64 Tests

Washington State Department of Health | 19

Immunization Increases during outbreak #10 through 18 year olds

Washington State Department of Health | 20

Immunization Increases during outbreak #119 years and older

MMR LEGISLATION

ActivationTotals

Jan-Mar 2019 Response*

May 2019 Response

2019Cumulative Total

Total Staff Involvement 222 81 303

Hours Worked 14,305 1,976 16,584

Total DOH Effort $1,011,100 $139,927 $1,151,027

Non-Budgeted Expenditures $152,800 $18,000 $170,800

Average Daily Cost $18,100 $9,328

Total Costs $1,011,100 $139,927 $1,151027

*Costs verified as of 10/3/19.

Washington State Department of Health | 23

In the News

Washington State Department of Health | 24

Legislative Update: EHB 1638

• Removes personal/philosophical exemption option for MMR vaccine.

o Public and private schools

o Licensed child care

■ Child care workers must provide MMR vaccine documentation or immunity

• Effective July 28th, 2019

• 2019-2020 School Year

• New Certificate of Exemption available online.

Washington State Department of Health | 26

Immunization Compliance Rulemaking: 246-105 WAC

• Changes to the rule:

• Definitions and clarified process

• Medically verified records requirements

• Modified religious membership exemptions

• Updated the ACIP reference.

• Draft Implementation Plan

1. Rule becomes effective: November 2019 & August 2020

Washington State Department of Health | 27

July 30, 2019

Outbreak affecting multiple counties:

o King (4), Pend Oreille (1), Snohomish (1), and Spokane (17)

o People living homeless or who use drugs.

Hepatitis A Outbreak

Total Confirmed Cases of Hepatitis A in Washington State (April 01, 2019 – September 5, 2019)

Cases Hospitalizations Deaths

23 15 0

Where do we go from here?

Washington State Department of Health | 30

It’s flu season, so…

Visit www.knockoutflu.org for flu news in Washington.

@WADeptHealth

Washington State Secretary of Health

jmwiesman@doh.wa.gov

John Wiesman, DrPH, MPH

Thank You!

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