National Awards Program Recognizes Outstanding Efforts During the 2011-2012 Influenza Season

Healthcare Providers improve access, knowledge and administration rates for influenza vaccination

Also available as PDF: 2012 NIVS Immunization Excellence Awards News Release [107 KB, 6 pages]

Contact: Mitchel Rothholz, 202-429-7549, mrothholz@aphanet.org

April 30, 2012 – Washington, D.C.

Recognizing the value and extraordinary contributions of individuals and organizations towards improved adult, adolescent, and/or childhood influenza vaccination rates within their communities during the 2011-2012 influenza season, the National Influenza Vaccine Summit is pleased to announce the recipients of the 2012 NIVS Immunization Excellence Awards. The awards will be presented during the National Influenza Vaccine Summit in Atlanta, Georgia, May 17, 2012.

There are four categories of recognition including overall season activities, healthcare personnel campaign, immunization coalitions/public health/community campaign, and corporate campaign. Nominees were evaluated based on the areas of impact, collaboration, originality, challenges and opportunities.

More than 32 nomination packets describing innovative programs were received this year. The Summit applauds all stakeholders who are working towards improving the health of their communities. The 2012 NIVS Immunization Excellence Award winners are as follows:

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Overall Season Activities

National Winner
USPHS/IHS/PIMC/Pharmacy Based Immunization Clinic (Phoenix, Arizona)

CDR Ann Gorman and LCDR Aimee Young are pioneers in the field of immunizations. Their efforts provided at the Phoenix Indian Medical Center (PIMC) & throughout the Indian Health Service are exemplified by the continuation and growth of pharmacist administered immunizations since 2007. CDR Gorman and LCDR Young have created and managed the PIMC Pharmacy Based Immunization Clinic (PBIC) for 5 influenza seasons. They have increased the number of providers in the clinic from 2 to over 30, the number of annual influenza immunizations from 460 to over 1400, and increased employee influenza immunization rates to over 80% for 2 years in a row. The PIMC immunization clinic augments influenza immunization services already provided at PIMC. Their clinic is now considered the “model immunization program” for the entire Indian Health Service (IHS). A recent survey of all IHS sites shows over 25% of the locations now have immunization clinics, most of which is due to the efforts provided by CDR Gorman and LCDR Young.

Healthcare Personnel Campaign

National Winner
Minnesota Department of Health (MDH) (St. Paul, Minnesota)

The Department of Health’s FluSafe program was established in 2010 to increase rates of health care personnel (HCP) influenza vaccination in Minnesota. Now nearing the end of FluSafe’s second year of operation, both hospitals and nursing homes that participate in FluSafe have higher vaccination rates than facilities that do not participate. The program facilitates friendly competition between health care facilities; creates transparency through public recognition; and supports thorough and accurate tracking of influenza vaccine coverage. FluSafe is a voluntary program. By choosing to participate each year, hospitals and nursing homes publicly demonstrate their commitment to patient safety. They design their own vaccination campaigns, enhanced in many cases by FluSafe’s evidence-based online tools and materials. At the conclusion of each influenza season, each facility’s HCP vaccination rate is measured using the Minnesota Immunization Information Connection (MIIC), the state immunization information system. Facilities that have achieved 70% or higher are recognized in an MDH press release and a listing on MDH’s website. These facilities are also provided with certificates, posters, and window clings to display. In addition, participants receive press release templates and sample newsletter articles to help publicize their achievements and build public awareness of the importance of HCP influenza vaccination. In FluSafe’s inaugural season, 137 hospitals and nursing homes participated. Of these, 109 were eligible for public recognition by reaching at least 70% HCP vaccination rates. Impressively, 27 facilities attained vaccination levels of 90% or greater, meeting the Healthy People 2020 goal and setting an example for their peers. FluSafe is now in its second season of operation, with a marked gain in participation to 214 facilities statewide. This represents 72% of hospitals and 27% of nursing homes in Minnesota. FluSafe facilities vaccinate more HCP than non-FluSafe facilities. The average Minnesota hospital’s HCP influenza vaccination rate in 2011 was 79%. Stratifying the results by FluSafe participation reveals a significant distinction: FluSafe hospitals’ average rate was 82%, while the average at non-FluSafe hospitals was only 73%. The difference is even more pronounced among nursing homes, with rates at FluSafe nursing homes reaching 75%, greater than both the state average (67%) and the average for non-FluSafe nursing homes (62%). FluSafe represents an advance over other HCP vaccination programs in that its use of MIIC to track vaccinations provides consistent documentation of vaccination rates. HCP vaccinations are tracked in the immunization information system to allow for consistent comparisons of formally documented rates —something not possible with programs that rely on self-report data. Another advantage of using MIIC is that it allows sites to track their own progress over the course of each season. FluSafe is supported statewide thanks in part to the professional organization leaders from around Minnesota that have been engaged from the very start. Its popularity is supported by the side benefits to facilities that participate: their use of MIIC for FluSafe purposes fulfills the vision of the Minnesota e-Health Initiative and may help them qualify for federal Meaningful Use incentives. Finally, in addition to its benefits to worker and patient safety, FluSafe has extended MIIC’s reach by providing an easy way for nursing homes to begin submitting data.

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Honorable Mentions—Healthcare Personnel Campaign

Children’s Hospital Colorado (Aurora, Colorado)
Within the hospital setting influenza vaccination encompasses making sure that high risk patients are vaccinated, families of high risk patients are vaccinated, and also important, ensuring that healthcare worker staff are adequately immunized. To address these overlapping yet unique issues, in 2008 an influenza task force was created at the Children’s Hospital Colorado. Since its inception the task force has worked hard to improve influenza vaccination communication, education, and healthcare worker immunization rates. As a team with many subgroups in the 2011/12 influenza season, the task force influenced a greater than 99% vaccination rates among healthcare workers, helped to encourage other teaching hospitals to adopt mandatory influenza vaccination policies, developed a comprehensive influenza vaccination tracking mechanism for real time data entry and compliance data, held a fun movie themed immunization campaign for staff, and administered over 3,900 free influenza vaccines to families of patients. Collaboration has always been the cornerstone in the Influenza Task force. Last year the hospital adopted a mandatory influenza policy that was developed by task force members. This year, two area hospitals adopted that same policy. The hospital’s policy also helped to guide the Colorado Board of Health to mandate influenza vaccine for Colorado healthcare workers beginning in the 2012/13 influenza season. The hospital’s IT group developed a web-based system so that employee consent and vaccinations could be entered by influenza captains throughout the hospital. This electronic system led to only a 3 minute wait or less for vaccine at our mass vaccination clinics and real time compliance monitoring for managers. Over 100 hospital staff members volunteered their time throughout the influenza season to administer influenza vaccinations to staff and to patients of families. The hospital’s Association of Volunteers contributed by donating over $40,000 so that families of high risk patients could receive influenza vaccinations for free. The Public Relations department developed a movie themed promotional campaign. This campaign featured the hospital’s CNO, one of the hospital’s Infectious Disease physicians, and the “flu bug” as a parody of the 1954 Classic “Creature from the Black Lagoon”. Teasers stated, “It’s Coming…it's infectious”, and the promotional movie posters stated, “The Flu” with the hospital CNO playing the leading role. A drawing for movie tickets for staff that were vaccinated before Thanksgiving was done to keep in the movie theme. The taskforce also held an influenza vaccination orientation session for nurses and pharmacists that volunteered to administer influenza vaccines to fellow healthcare workers. This orientation session helped our influenza ambassadors to debunk myths staff may have about influenza vaccine, taught them proper immunization administration and handling skills, and gave them the tools to enter influenza vaccination data into our web based system. In all of the activities described above, staff from departments of the hospital who may have never worked together before came together under one common goal, keeping our hospital, or patients, and our families, free from influenza disease.

Colorado Department of Public Health & Environment (Denver, Colorado)
On February 15, 2012, the Colorado Board of Health passed a rule requiring Colorado’s health care facilities to ensure annual influenza vaccination of their health care workers. The Colorado rule was a product of a yearlong collaboration between the Colorado Department of Publi Health and Environment (CDPHE) and stakeholders across the state. As a direct result of the extensive collaborative approach taken, the final rule is unique among similar proposed and enacted state mandates in that it addresses a variety of health care facility needs and priorities relating to reporting, implementation, and enforcement. The rule applies to all licensed health care entities in Colorado. The Colorado rule was modeled to encourage facilities that are already appropriately implementing strategies to prevent influenza to continue to do so, to assist facilities that can improve, and to prompt facilities to adopt more effective policies to prevent influenza. The rule achieves this by allowing facilities that have already taken measures to ensure patient safety by promoting or mandating influenza vaccinations to be exempt from the rule if target vaccination rates (phased in to 90% in 2014) are reached. A facility can implement a policy that best fits its organization to achieve or exceed the target vaccination rates, including implementing any type of exemption or informed declination as long as it gets to the target vaccination rates described below. If a facility does not achieve the target vaccination rates, it is required to implement an influenza vaccination policy for health care worker that includes a medical exemption only and a requirement for workers that have not been immunized to wear a surgical mask during influenza season. As described above, the rule applies to all hospitals, ambulatory surgical centers, and long term care facilities in the state. The rule also applies to other licensed health care entities in the state including community clinics, rehabilitation centers, community mental health centers, facilities for people with developmental disabilities, hospice care, assisted living residences, dialysis treatment clinics, birthing centers, home care agencies, maternity hospitals, psychiatric hospitals, convalescent centers and acute treatment units. These facilities must achieve the same target vaccination rates to be exempt from the rule, but instead of mandatory immunization (medical exemption only) and masking requirements if targets are not reached, these facility types must perform an assessment of their workforce and residents/patients and develop an influenza vaccination policy regarding the vaccination or masking of their employees based upon that assessment. This two-tiered approach was adopted in response to feedback from facilities on unique implementation challenges and differences in community exposure in the second grouping of facilities. Engaging stakeholders in the development of the Colorado rule on health care worker influenza immunization was a substantial investment but yielded innovative public health policy that was successfully passed by the Colorado Board of Health. This approach can serve as a model for other states, particularly those that have attempted but been unsuccessful at passing mandatory health care worker immunization legislation.

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Immunization Coalitions/Public Health/Community Campaign

National Winner
Caring for Children Foundation of Texas’ Care Van Program (Richardson, Texas)

The program is a 501c3 immunization outreach program that provides free access to immunizations for uninsured and medically underserved Texas children. Partial funding was obtained from Healthy Kids Healthy Families Grant Program and Blue Cross and Blue Shield of Texas paid all of the administrative cost for the Care Van Program. The program has a fleet of 10 brightly colored, kid-friendly vans strategically located across the state of Texas. The Care Van programs are designated providers for the Texas Vaccines for Children Program, a federal /state program which allows free vaccine to providers for administration to children birth to 18 years of age. Children who qualify for the program receive all recommended and required vaccines, as well as educational information and vaccine guidance for parents. Because these are mobile clinics rather than a brick and mortar location, Care Van is able to go into areas that are seriously underserved by other vaccine providers. Texas ranks 48th in the nation for uninsured children making it difficult for many children to have a medical home. As a result, a large number of children have no access to regular medical care including immunizations. Immunizations are proven to be one of the most cost effective measures to eliminating vaccine preventable diseases. This includes yearly influenza vaccine protection. In 2010-2011 the Care Van collaborated with Dallas County Health and Human Services, Grand Prairie Independent School District, Blue Cross and Blue Shield of Texas, Caring for Children Foundation of Texas and Healthy Kids Healthy Families Grant Program to offer free school based flu mist/shots to uninsured or underserved elementary age children. This flu initiative was launched by Grand Prairie Independent School District (ISD) due to the large number of absences due to flu related illnesses during the 2009-2010 school year. There was already a close public/private relationship between Dallas County and the Care Van program so this was a natural fit. Of course there was the obvious obstacle to over come; funding. The Care Van and Dallas County split the 24 schools providing staff at their designated schools. Two clinics were held each day in the morning and afternoon. Each collaborating partner had defined roles and responsibilities with written instructions for each role. This flu initiative was offered in all 24 Grand Prairie ISD elementary schools, during school hours, giving parents a way to protect their children without causing undue hardship due to lost time at work, lack of transportation or language barriers. Taking the project one step further, it was decided to make this collaboration a three-year initiative designed to improve the health and wellness of children through flu illness prevention. The data for this flu initiative was easily measurable and demonstrated the importance of vaccinating against the flu. The results were better than anticipated with over 32% of the elementary school population participating in this flu initiative. The district has reported that daily attendance increased over the previous year. One school had a 10% increase. Attendance rates rose from 93.6% to 94.9% which is an increase of 1.42%. Over all it was estimated that in 2010-2011 GPISD saved over $600,000 due to the increase in attendance and the decrease in flu related illnesses. With the tremendous results in Grand Prairie ISD a new goal was set in 2011-2012 school year to expand the flu initiative. In addition to Grand Prairie ISD the Care Van offered the free flu immunization program in three other school districts; Richardson ISD, Carrollton ISD, Duncanville ISD. These schools were located in Dallas, Collin and Tarrant counties. With a staff of 2 to 3 nurses, a paramedic and the help of volunteers at the various school districts Dallas County, Blue Cross Blue Shield of Texas, Tarleton State University and the Care Van program was able to provide flu vaccine to over 10,600 children in North Texas in just 3 short months. Statistics for the 2011-2012 season will not be tabulated until May 2012.

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Honorable Mention—Immunization Coalitions/Public Health/Community Campaign

The Immunization Partnership (TIP) (Houston, Texas)
The Partnership contributed towards improved influenza vaccination rates in the greater Houston area in all three of their focus areas: Advocacy, Education and Support of Immunization Information Systems. One of TIP's focus areas is Advocacy. For this flu season TIP engaged in extensive stakeholder engagement, surveying community advocates and gathering data to make immunization advocacy and policy a cornerstone effort of the organization. TIP was instrumental in the passage of several Texas immunization-friendly laws including the Healthcare Worker Vaccination Law. This new law requires healthcare facilities such as hospitals to develop and implement vaccination polices to protect patients from vaccine-preventable diseases. It also requires healthcare facilities to include the following in their policies: 1) identification of which vaccines are required for their employees including gate influenza vaccine, 2) procedures for verifying compliance with vaccine policies, 3) procedures for medical exemptions, 4) procedures that unvaccinated employees must follow to ensure the patients are protected from exposure to disease, 5) requirements that facilities maintain a system for documenting the vaccination status of their employees, 6) disciplinary actions that facilities are authorized to take against employees who fail to comply with the policies. For the success of this legislation, TIP collaborated with a score of healthcare organizations, membership groups, stakeholders and coalitions such as the Austin Immunization Collaborative, Immunize San Antonio, One Voice Coalition, Texas Hospital Association, Texas Medical Association, Texas Association of Family Practitioners and others. TIP’s Education focus area on influenza involved several private and public partners includng: Baylor College of Medicine, Families Fighting Flu, Harris County Hospital District, Houston Community College, Houston Department of Health and Human Services, Houston Independent School District, Methodist Hospital, Rotary Club of Houston, Texas Children’s Hospital, University of Texas Health Science Center at Houston, and University of Texas School of Medicine. In conjunction with Houston Community College’s Coleman College for Health Sciences, TIP sponsored a Flu Summit on October 19, 2011. Attended by approximately 85 persons from academia, healthcare and government sectors as well as students of the health sciences, this summit addressed flu’s effect on pregnancy, infection control in hospitals and epidemiology of influenza. Community Immunity, developed by TIP, was created in response to a need for simplified explanations to help members of the community understand the importance of getting immunized to protect individuals and communities from the spread of dangerous vaccine-preventable diseases. Using influenza as the highly communicable vaccine-preventable disease, 15 Community Immunity presentations were made to more than 1,000 persons in the greater Houston area by TIP and by its collaborator, the Rotary Club of Houston. TIP promoted influenza vaccine and discussed the dangers of influenza in nine media presentations on English and Spanish TV stations and English-speaking radio stations. These presentations aired 14 times and reached 458,060 people with our message. In the Fall of 2011, TIP collaborated with the Houston Department of Health and Human Services to mail influenza information to 350 Houston area Vaccines for Children providers. Lastly, TIP's Support of Immunization Information Systems encompasses TIP programs which focus on immunization registry best practices. During 2011 – 2012, TIP coordinated a program in a Houston area Federally Qualified Health Center (FQHC) utilizing Texas’s registry: ImmTrac, to remind adult diabetic patients to receive the influenza vaccine. Not only were patients immunized, they consented to be added to ImmTrac. More than 300 diabetic patients were recalled for the influenza vaccine. TIP provided influenza educational materials to several FQHCs, and other public and private clinics.

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Corporate Campaign

National Winner
Walgreens (Deerfield, Illinois)

As the nation’s largest national pharmacy chain, Walgreens has increased vaccination rates for influenza and improved the public health of the nation by implementing immunization programs that are creative, original, and innovative. These programs expanded access and convenience to influenza vaccinations throughout the United States and have helped alleviate health disparities in underserved communities. By establishing a nationwide capacity to vaccinate patients, Walgreens is transforming the role of the pharmacy into a destination for health and wellness.

Utilizing the power of social media, Walgreens was able to promote influenza awareness and provide flu shots to the underserved at an exponential rate. From September to early October 2011, every time a customer “checked-in” to a Walgreens store via Foursquare or Facebook Places, a flu shot was donated to an uninsured, underinsured, or financially in-need person. Each check-in to Walgreens was followed by a prompt for further action by voting for one of five charities by “liking” the charitable organization on Facebook. Through the campaign, Walgreens donated a combined $6 million of flu shot vouchers to the following charitable organizations: Feeding America, American Diabetes Association, AmeriCares, National Urban League, and the League of United Latin American Citizens. Engaging customers with the social media campaign produced excitement around flu shots, promoted altruism, and enabled customers to feel more connected to their community.

In addition to leveraging social media platforms, Walgreens established a nationwide infrastructure of community outreach that has helped increase influenza vaccination rates in the underserved community. In December 2010, Walgreens introduced an initiative to address health disparities in minority communities and underserved populations. In partnership with the United States Department of Health and Human Services (HHS), Walgreens has collaborated with over 700 community organizations and donated over 600,000 flu shots (approximately $20 million value) to those most in need.

Walgreens also increased influenza vaccination rates in or near areas classified as food deserts. An estimated 2.3 million United States households are located more than a mile away from a grocery store and do not have access to a vehicle; the United States Department of Agriculture (USDA) refers to these communities with limited access to grocery stores as food deserts. In 2010, Walgreens converted several existing locations into food oasis pharmacies, providing access to fresh fruits and vegetables in urban neighborhoods of Chicago located in or adjacent to food deserts. The promotion of healthy nutrition in these stores may be correlated with other healthy behaviors, such as receiving an annual influenza vaccination. In food oasis pharmacies, the rate of influenza vaccinations increased by 75% from the 2009-10 to 2010-11 influenza seasons, compared to a year-over-year increase of 50% observed in neighboring traditional stores. The introduction of food oasis pharmacies, as healthy destinations near food deserts, has further contributed to the observed increase in the rate of influenza vaccinations.

Walgreens has also increased vaccination rates for influenza by enacting various initiatives in the underserved community. The “Three-and-Out” campaign donated 50 free flu shot vouchers to Chicagoland families in need every time the Chicago Bears defense successfully forced a "three-and-out". The Walgreens Wellness Tour deployed buses across the country, distributing free flu shots to those who were uninsured, underinsured, and those who could not afford their flu shot without the assistance of the voucher. The First Ladies Health Initiative was a Walgreens-sponsored campaign to educate African Americans about preventive illnesses that disproportionately affect Black communities and to administer flu shots to those in need. Walgreens also partnered with the Assembly of Petworth, a stakeholder partner for the Washington, D.C. campaign, in undertaking aggressive outreach efforts to ensure that vaccination is available to the neediest metropolitan D.C. residents. Lastly, Walgreens collaborated with the General Colombia Consulate in Miami, FL by hosting a vaccination clinic to help increase awareness of influenza vaccination among Hispanics in the tri-county Miami-Dade, Broward, and West Palm Beach area.

Walgreens has been exemplary in increasing coverage levels for influenza by implementing innovative immunization programs to expand access and convenience throughout the United States, including underserved communities. Through these diverse vaccination initiatives, Walgreens is transforming the role of the pharmacy into a destination for health and wellness and is improving the public health of the nation.

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Honorable Mention—Corporate Campaign

Vanderbilt University “Flulapalooza” (Nashville, Tennessee)

On October 12, 2011, Vanderbilt University and Medical Center conducted a mass vaccination event called “Flulapalooza.” The primary goal of the event was to test our pandemic mass vaccination plan, utilizing seasonal flu vaccine. In the event of a pandemic, Vanderbilt has an agreement with the Metro Nashville Health Department that we will assume responsibility to vaccinate or treat approximately 60,000 people including our employees and their families, and our students. To generate the high volumes we would anticipate in a pandemic, they decided to stimulate interest by challenging the Guinness World Record for most vaccines given in one day, so their secondary goal was to break the existing record of 6,215 vaccines in 8 hours. The challenge was not only to deliver vaccines, but to coordinate logistics and communications on such a large scale, to document appropriately, and to deliver the vaccine in a safe and controlled environment. Ultimately they set a new Guinness World Record, more than doubling the existing record, with 12,850 flu vaccines in 8 hours and 14,082 vaccines for the entire day. As the largest private employer in the state, Vanderbilt’s faculty, staff, and students comprise a significant segment of the Nashville community. In addition to the direct effect of vaccinating over 14,000 individuals in the community, the local media coverage of Flulapalooza was extensive. This served to generate interest and excitement about flu well beyond the approximately 35,000 faculty, staff, and students invited to the event.

About the National Influenza Vaccine Summit (NIVS)

The National Influenza Vaccine Summit started in the year 2000, is co-sponsored by the American Medical Association and the Centers for Disease Control and Prevention. The Summit is an action-oriented entity with over 400 members who represent over 100 public and private organizations with an interest in addressing and resolving influenza and influenza vaccine issues. Visit the Summit’s website at www.PreventInfluenza.org.

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