friday 2.15 pm adolfo valadez prevention and preparedness division
DESCRIPTION
Adolfo Valadez presents on Prevention and Preparedness DivisionTRANSCRIPT
Texas Immunization System
Dr. Adolfo ValadezAssistant Commissioner
Prevention and Preparedness Services
• Essential Public Health Functions• Top 10 Public Health Achievements• Public Health Impact of
Immunizations• Economics of Immunizations • Vaccine Coverage Levels• Disease Incidence Trends• Texas Vaccines for Children Program • ImmTrac
Agenda
Essential Public Health Functions
• Monitor health status of community• Investigate health problems in community• Inform, educate, and empower stakeholders• Forge community partnerships• Develop health policy and support planning• Enforce health code and regulations• Link people to appropriate health resources• Assure a competent public health workforce• Evaluate the quality and effectiveness of efforts• Research and innovation in community health
10 Greatest Public Health Achievements 1900-1999
Healthier moms and babies
Safer workplace
Safer and healthier
foods
Tobacco as a health hazard
Decline in deaths from coronary heart disease
Fluoridation of drinking water
Motor-vehicle safety Family Planning
Vaccinations
&
Control of Infectious Disease
Public Health Impact of Immunizations
• Considered one of the greatest public health achievements of the 20th century
• At the beginning of the 20th century vaccine-preventable disease morbidity and associated mortality was widespread
• Morbidity for 9 vaccine-preventable diseases has declined dramatically
• Smallpox eradicated, wild polio eliminated from Western Hemisphere
Source: Centers for Disease Control & Prevention
• For each birth cohort vaccinated in accordance with the schedule*– 33,000 deaths are prevented– 10.5 million cases of diseases are
prevented
• Vaccinations have huge cost savings– $10.5 billion in direct costs– $42 billion in societal costs
Economics of Immunizations
Zhou F, et al. Archives of Pediatrics and Adolescent Medicine, in press
*(DTaP, Td, Hib, MMR, Hep B and Varicella)
• For every $1 spent on an individual vaccine:– DTaP saves $27– MMR saves $26– Perinatal Hep. B saves $14.70– Varicella saves $5.40– Inactivated Polio (IPV) saves $5.45
Economics of Immunizations
Zhou F, et al. Archives of Pediatrics and Adolescent Medicine, in press
Healthy People 2010 Goal-Individual Vaccines-90%
Vaccine TX
DTP/DTaP 4+ 82.1%
Polio 3+ 92.6%
MMR 1+ 90.4%
Hib 3+ 93.8%
Hep B 3+ 91.7%
Varicella 1+ 90.0%
2007 National Immunization Survey
Healthy People 2010 Goal-4:3:1:3:3:1 Combination-80%
Texas 2007 National Immunization Survey Data--77.3%, 2.7 percentage points away from the national goal
2007 National Immunization Survey
National Immunization Survey2002–2007, Texas and US Rates Compared
(Texas Ranking Among the States Appears in Bold Below Data Points)
60
65
70
75
80
85
4:3
:1:3
:3:1
Vaccin
e C
overa
ge L
evel
Texas United States
Texas 65 69.8 69.3 76.8 74.7 77.3
United States 65.5 72.5 76 76.1 77 77.4
2002 2003 2004 2005 2006 2007
4129
24
24
*4-3-1-3-3-1: 4 doses DTP, 3 doses Polio, 1 dose MMR, 3 doses of Hib, and 1 or more doses of varicella
34
22
• 1985 (7)
– Measles
– Rubella
– Mumps
– Diphtheria
– Tetanus
– Pertussis
– Polio
Number of Vaccines in the Routine Childhood Schedule
• 1996 (10)
– Measles
– Rubella
– Mumps
– Diphtheria
– Tetanus
– Pertussis
– Polio
– Hib (infant)
– Hepatitis B
– Varicella
• 2008 (16)– Measles
– Rubella
– Mumps
– Diphtheria
– Tetanus
– Pertussis
– Polio
– Hib (infant)
– Hepatitis B
– Varicella
– Hepatitis A
– Pneumococcal Disease
– Influenza
– Meningococcal
– Rotavirus
– HPV
• 2001 (12)
– Measles
– Rubella
– Mumps
– Diphtheria
– Tetanus
– Pertussis
– Polio
– Hib (infant)
– Hepatitis B
– Varicella
– Hepatitis A
– Pneumococcal
Conjugate
Nationally Proven Strategies to Raise Vaccine Coverage Levels
• Promote the medical home concept• Promote the use of registries• Promote reminder/recall• Public education• Provider education• Utilize community partners to improve in the
strategies listed above
TVFC Public vs. Private Doses Administered Percentage
80
.7
19
.3
75
.82
4.2
73
.82
6.2
66
.43
3.6
62
.6
37
.4
58
.4
41
.6
56
.24
3.8
55
.84
4.2
55
.54
4.5
51
.24
8.8
53
47
49
.65
0.4
44
56
37
.86
2.2
36
.96
3.1
34
66
0
10
20
30
40
50
60
70
80
90
FY 92 FY 93 FY 94 FY 95 FY 96 FY 97 FY 98 FY 99 FY 00 FY 01 FY 02 FY 03 FY 04 FY05 FY06 FY07
Public Private
Per
cent
of T
otal
ed E
nrol
led
$5,432,585
$92,070,825
$15,450,714
$3,299,278
$143,773,200
$17,902,978
$6,501,248
$203,135,422
$15,265,808
$19,846,223
$224,822,864
$10,711,609
$0
$50,000,000
$100,000,000
$150,000,000
$200,000,000
$250,000,000
$300,000,000
2004 2005 2006 2007
317 Vaccine (DA + FA) VFC Vaccine (DA) State GR Vaccine Purchases
TEXAS Total Vaccine Purchases: 2004-2007
Federal Vaccine Purchases based on a calendar year (January through December)Texas GR Vaccine Purchases based on a state fiscal year (September through following August)
TVFC Site Visits by YearPublic & Private Clinics
354
872 831 884
2,408
328
2,405
247
2,646
300
2,775
273
0
500
1,000
1,500
2,000
2,500
3,000
2001 2002 2003 2004 2005 2006
TMF HSR/LHD
ImmTrac Health Plan Participation
• 35 health plans reporting• >5 million immunizations added to
ImmTrac client records in 2007 (Medicaid and health plans)
• 23 immunization history request files submitted by 8 health plans
• >27 million immunizations conveyed to health plans for their members
ImmTrac Snapshot: Q4 2007
• >67 million immunizations recorded
• 5.6 million Texas children
• 2 million children under age 6
• >4,300 active online user sites
• >62,000 immunization history reports generated online per month (avg)
Immunizations Reported by Electronic Data Import - 2007
Public Health 3.6 M
Local Registries 1.7 M
Private Providers, Hospitals 1.0 M
Medicaid, Health Plans 5.1 M
>11 Million Immunizations Reported +47% over 2006
ImmTrac Active User Sites
0
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
4,500
2003 2004 2005 2006 2007
33% Increase in 2007
0
100,000
200,000
300,000
400,000
500,000
600,000
700,000
2002 2003 2004 2005 2006 2007
ImmTrac Immunization Histories Generated
>80% Increase in
2007
Immunization Branch
512-458-7264 or 800-252-9152
www.ImmunizeTexas.com