The HA2030 kept a childhood immunization objective similar to LHI 17 from the HA2020 plan, but changed it to specifically track only the DTAP vaccine to reflect the change in the data source, the National Immunization Survey questions. This objective remained in the plan since it can be tracked annually on a national level and the strategies to increase the immunization rates are incorporated into the State of Alaska’s strategic plan.
Due to the high rates of chlamydia, gonorrhea, HIV, and syphilis in the state of Alaska, the team determined it was important to keep an objective focused on sexually transmitted infections. Because strategies and actions to lower the rates of infectious disease spread are similar for each of the STIs, the team decided to choose one to focus on for data collection because the strategies and actions would address the others. Another reason that just one STI was selected for inclusion in the HA2030 plan is because the Healthy Alaskans Data Team did not at the time have the capacity to track, monitor and report on all of the STIs. Gonorrhea was chosen over the past focus of Chlamydia because it isan STI that has more serious and broader reaching health implications, has had a steady uptick in cases in AK, and has the funding for efforts to contact trace cases and implement other interventions.
Client reminder and recall interventions are used to remind members of a target population that vaccinations are due (reminders) or late (recall). Reminder/recall systems are cost-effective methods to identify and notify families whose children are due soon from immunizations or are already behind. State immunization information systems (IIS), like VacTrAK, and electronic health records (EHRs) can run reports of patients who are due or overdue easily. The Community Prevention Services Task Force (CPSTF) recommends client reminder and recall interventions to increase vaccination rates in children, adolescents, and adults.
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Immunization information systems (IIS) (i.e., VacTrAK) are confidential, population-based, computerized databases that record all immunization doses given by participating providers to people who live within a certain geopolitical area. CPSTF recommends IIS to increase vaccination rates.In 2008, the Immunization Program implemented the Alaska Immunization Information System (IIS), VacTrAK, in order to provide centralized immunization information for the entire State. The Alaska IIS provides integrated reporting functionality, vaccine ordering and management, clinical decision making tools, and the ability to both import and export data in a variety of formats.The 2017 Immunization Information System Annual Report (IISAR) (required by CDC Cooperative Agreement) cites the 2017 NIS 4:3:1:3:3:1:4 series coverage percentage for children aged 19 through 35 months as 69.5%, while the Alaska IIS is reported as 58.5%. This difference is attributable to a number of factors, including a census (i.e., IIS) versus a sample (i.e., NIS), incomplete data, and/or problems with data quality in the Alaska IIS.
Provider reminders let healthcare providers know when clients are due for specific vaccinations. Reminders are delivered in various ways that may include notes posted in client charts, alerts in electronic medical records, or letters sent by mail or e-mail. They may be handled separately or included in standard checklists or flowcharts. CPSTF recommends provider reminders – when used alone or when combined with additional interventions – to increase vaccination rates among people of all ages from different populations or settings.
While most Alaskans choose to vaccinate, we still have individuals and pockets of populations who are not immunized or under immunized, thus leaving some individuals and communities at risk for preventable diseases and outbreaks. The compounded effects of social determinants of health, and misinformation, continue to affect immunization coverage. CDC is promoting a new framework that takes a broader community focus to engage and protect people. Vaccinate with Confidence is a framework designed to strengthen vaccine confidence by protecting communities, empowering families, and stopping myths. Increasing multidisciplinary collaboration, of state and local partners, supports collective engagement and community initiatives that address social determinants of health and inequities within the context of where Alaskans live, learn, work, and play.
Alaska’s Neisseria gonorrhoeae infection (GC) rates are among the highest in the United States. Undiagnosed GC can lead to serious health sequelae and can increase the likelihood of acquiring human immunodeficiency virus (HIV) by a factor of 2 to 5 times when having unprotected sex with an HIV-infected partner.Recent reports indicate that urogenital-only testing can miss asymptomatic GC infections, particularly among men who have sex with men (MSM) and heterosexuals who engage in oral and anal intercourse. The importance of taking a thorough sexual history to identify, treat, and stop transmission of GC infections in both high-risk and more general risk populations cannot be overstated. Using open-ended questions posed in a non-judgmental, sensitive manner is essential in taking a good sexual history. For guidance and resources in effective risk assessment techniques, visit the SOE Sexual History Taking webpage (available at: www.epi.alaska.gov/hivstd/history.htm).Routinely collecting specimens for testing, using EHR screening reminders, and reminding patient to get screened or rescreened are cost-effective methods to detect and reduce incidence of STDS.
CDC updates guidelines after consultation with a group of professionals knowledgeable in the field. Last meeting 2013 for the 2015 guidelines.
To engage innovative strategies which could modify health outcomes in the era of competing demands on public health funding. Ensuring the interventions, to reduce the incidence of Gonorrhea and other STIs, utilize a broad lens with a long-view perspective of how where people live, learn, work, and play, affects health. To change our current trajectory of continued increasing STI rates, moving upstream to address factors that contribute to the risks. A persons’ decision on lifestyle choices are complex and multifaceted. Improving protective factors and addressing risk factors are dynamic as well and have the capacity to affect multiple health outcomes across the lifespan.
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