Health Care Professionals

• Vaccine Preventable Disease Reportable Cases Chart 1998-2008

• Vaccine Preventable Disease Surveillance Report 2007
• Vaccine Preventable Disease Surveilance Report 2006
• Vaccine Preventable Disease Surveillance Report 2005
• Vaccine Preventable Disease Surveillance Report 2004
• Vaccine Preventable Disease Surveillance Report 2003

• Pediatrics AAP Journal 2010-03, Parental Vaccine Safety Concerns in 2009
• Pediatrics AAP Journal 2010-02 Serotype 19A Is the Most Common Serotype Causing Invasive Pneumococcal Infections in Children
• Vaccine 28 Journal 2010 How the Wakefield paper, the press and advocacy groups damaged the public health
• Vaccine 28 Journal 2010 A postmodern Pandors's box: Anti-vaccination Misinformation on the Internet

Role for operational research to improve immunization services

Immunizations can serve as an excellent probe of how well systems work in an office. The innovative Assessment, Feedback, Incentives, eXchange (AFIX) Plus project addresses practice systems by looking at missed opportunities for vaccination.

Published data demonstrate that provider missed opportunities are a significant cause of failure to get children up to date on time.

The goal of this project is to improve immunization practices by examining root causes for and then reducing missed opportunities to vaccinate by 20% below baseline assessment. AFIX Plus monitors office processes or systems instead of outcomes. It maintains methodological rigor while being cost-effective and provides immediate feedback and results. The role of the public health nurse in this process is as a facilitator rather than an auditor.

Is your practice ready to implement an innovative quality improvement project?

We believe you care more about your patients than an outside agency. The focus of AFIX Plus is to help providers do the best possible job they can in vaccinating Colorado’s children by minimizing missed opportunities for vaccination.

The Colorado Immunization Program (CIP) is invested in helping providers implement AFIX Plus. As an added value to providers who participate in the AFIX Plus project, the CIP along with the Colorado Chapter of the American Academy of Pediatrics and the Rocky Mountain Youth Clinics worked collaboratively and successfully to gain the approval of AFIX Plus by the American Board of pediatrics to serve as a qualified QI project for Colorado pediatricians seeking their maintenance of certification.

AFIX Plus Protocol

1. Provider office staff collect and control the data

2. Missed opportunities are identified and measured

3. Record review occurs monthly assessing 5 randomly selected records per every provider in the office with prescriptive rights -of patients less than 24 months of age or who were seen in the office within the last 30 days; All visit types reviewed; Office designee reviews records and enters data into web-based online tool, setting aside records of children with identified missed opportunities

4. Clinic medical director and/or QI committee provides feedback to individual providers immediately; Aggregate data is collected and analyzed and used as group discussion material exploring the “whys;” Practice results not be shared with anyone

5. Colorado Immunization Program public health nurse personnel act as resident experts providing tools, trainings and protocols. Program also captures best practices and disseminates common solutions to common problems.

Please contact Lori Stonehocker Quick by phone 970-375-2579 or email if you would like additional information about the AFIX Plus project. Learn how your office or clinic may participate in the project at no direct cost to your clinic.

• Immunization Forms for Healthcare Settings
• Immunization Schedules
• Translation of Common Immunization terms 2003-10

• Colorado Immunization Manual

•   Influenza Immunization Healthcare Worker Toolkit 2012-12-18

• Colorado Immunization Information System
• Colorado Vaccines For Children Program

• Immunization Action Coalition (IAC) Vaccine Information Statements (VIS)

• Information about Vaccine Safety
• VAERS Info
• Report an adverse event
• Vaccine Safety Data Link Project

• Allied Vaccine Group
• CO Clinical Guidelines Collaborative
• American Academy of Pediatrics
• Johns Hopkins University
• Provider Resources for Vaccine Conversations with Parents
• Vaccine Ethics
• Voices for Vaccines

• Translation of Common Immunization terms 2003-10