Immunize Georgia, Vol. 1 (Mar. 2006)

What's Inside

2 Stay Up to Date Immunization 2006
5 GRITS Eastman Pediatrics

4 12th Annual IGLG Conference Awards
Insert Parent Pages

Immunize 2006vol.1
Georgia
A PUBLICATION OF CHILDREN'S HEALTHCARE OF ATLANTA AND DHR'S GEORGIA IMMUNIZATION PROGRAM

IGLG Grows with a New Focus
Protecting against vaccine-preventable diseases is a family affair and should include all ages.

With this in mind, Children's Healthcare of Atlanta and DHR's Georgia Immunization Program agree it makes sense to change the name of Immunize Georgia's Little Guys (IGLG) to simply Immunize Georgia (IG). Being the mission of Children's Healthcare of Atlanta, the focus will remain on protecting our youngest, but will also include related information for the family, household members and caregivers.

IGLG was launched more than 12 years ago with the goal of promoting childhood immunizations in Georgia. More importantly, the primary focus at that time was to make sure that "every child by two" was immunized. The goal has evolved from a specific focus on the "little guys" to a broader lens which includes adolescents,
young adults and adults.

Some vaccine preventable diseases, such as pertussis, spread to children from

adolescents and adults. It can pass from caregivers and household members to

infants who may not be fully protected. Pertussis can be deadly for infants. Protecting

adolescents and adults has the ultimate outcome of protecting the child. Likewise,

children are considered "high-transmitting population groups" ** and can spread

diseases such as influenza, hepatitis A and varicella to adolescents, young adults or

In 2006, Immunize Georgia will focus on the family and protecting Georgia's communities.

the elderly. Many vaccines are now being recommended for all age groups in order to protect across the lifespan.
** National Foundation for Infectious Diseases statement, http://www.nfid.org/docs/statement.pdf.

Spot Light

Stay Up to Date Immunizations 2006
Keeping up to date is a real challenge for providers. In 2005, the Food and Drug Administration (FDA) approved licensure for five new vaccines (Menactra, Boostrix, AdacelTM, ProQuad and FluarixTM) and expanded the licensure of three existing ones (Varivax, Havrix and Vaqta).

One new vaccine, RotaTeq, has already been licensed in

Adolescents 11 to 12 years of age should receive a single

2006, and more are expected to be approved by the end of

dose of Tdap instead of Td if they have completed their

this year. The Advisory Committee on Immunization Practices

recommended childhood DTP/DTaP vaccination series and

(ACIP) has published Recommendation Statements or provisional

have not received a Td booster.

recommendations for these newly licensed vaccines. In addition,

Adolescents 13 through 18 years of age who missed having

each year the ACIP, the American Academy of Pediatrics and the

a booster shot at age 11 to12 should also receive a single

Academy of Family Physicians update the Recommended

dose of Tdap if they have completed the recommended

Childhood and Adolescent Immunization Schedule.

DTP/DTaP vaccination series.

The following is a summary of the major revisions to the 2006 schedule and the new or revised ACIP recommendation statements. For the most comprehensive information on the 2006 schedule, please go to http://www.cdc.gov/nip/recs/ child-schedule.htm. Be sure to review the footnotes section. As recently approved and new vaccines become available for distribution through the Georgia Vaccines for Children (VFC) Program, VFC providers will be notified.

Providers should administer Tdap and MCV4 (see below) during the same visit if both vaccines are indicated and available.
Adults 19 through 64 years of age who have or anticipate having close contact with an infant less than 12 months of age should receive a single dose of Tdap (AdacelTM).**
Pregnant women should receive a dose in the immediate post-partum period if they have not previously received Tdap.**

Hepatitis B Vaccine (Hep B) The first dose of hepatitis B should be given soon after birth
and before hospital discharge. Vaccination of infants born to hepatitis B surface antigen
(HBsAg) negative mothers can be delayed in rare circum-

Information on dosing intervals can be found in the ACIP statement at http://www.cdc.gov/mmwr/preview/ mmwrhtml/rr5503a1.htm.* Special situations and contraindications can be found in Appendix C of that statement.

stances, but only if a physician's order to withhold the vaccine and a copy of the mother's original HBsAg negative laboratory report are documented on the infant's medical record. Administering four doses of hepatitis B vaccine is permissible (e.g., when combination vaccines are administered after the birth dose); however, if monovalent vaccine is used, a dose at four months is not needed. Specific recommendations for dosing intervals are included in the ACIP statement. Infants born to HBsAg positive mothers should be tested for immunity or infection at 9 to 18 months of age after completion of the vaccine series at 6 months of age. For more detailed information, please refer to http://www. cdc.gov/mmwr/preview/mmwrhtml/rr5416a1. htm. * Be sure to note the Erratum dated February 17, 2006/55; No. RR-16.

Meningococcal Vaccine (MCV4 and MPSV4) Meningococcal Conjugate Vaccine (MCV4) was
approved by the FDA in January 2005 for persons 11 through 55 years of age and was added to the list of routinely recommended vaccines included on the 2006 schedule. Meningococcal Polysaccharide Vaccine (MPSV4) was also added to the schedule for administration to high-risk children 2 to 11 years of age. MCV4 is the preferred vaccine for people 11 through 55 years of age, but meningococcal polysaccharide vaccine (MPSV4) can be used if MCV4 is not available. MPSV4 should continue to be used for children 2 to 11 years of age and adults over 55 who are at risk. The following populations at increased risk for meningococcal disease are recommended to be vaccinated with MCV4:

Tetanus, Diphtheria, Acellular Pertussis Vaccine (Tdap) Two brands of Tdap vaccine were licensed in 2005
(AdacelTM for persons 11 through 64 years of age and Boostrix for persons 10 through 18 years of age). Tdap was added to the list of routinely recommended vaccines included on the 2006 schedule.

o Adolescents 11 to 12 years of age at the pre-adolescent healthcare visit
o Adolescents at high school entry (approximately 15 years of age) who were not vaccinated at the preadolescent visit
o College freshman who live in dormitories (MCV4 preferred but MPSV4 acceptable) continued on page 3

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Immunize Georgia / 2006 / VOL. 1

Spotlight continued from page 2
For information on the "Prevention and Control of Meningococcal Disease," please see the ACIP statements at http://www. cdc.gov/mmwr/PDF/rr/rr5407.pdf* and http://www. cdc.gov/nip/vacsafe/concerns/gbs/menactra.htm.
Influenza Vaccine In the 2006 schedule, the footnote discussing influenza vac-
cine was revised to include these additional risk factors for children 6 months of age and older: "conditions that can compromise respiratory function or the handling of respiratory secretions or that can increase the risk for aspiration." At its February 2006 meeting, the ACIP voted to recommend that ALL children 6 through 59 months of age and their family members or caregivers be vaccinated against influenza each year. It will be critical to begin educating parents and families now about the new provisional** influenza recommendations effective for the 2006-07 influenza season. The new influenza recommendations should be considered when ordering flu vaccine for the 2006-07 influenza season. The American Academy of Family Physicians has information on "Ordering Influenza Vaccine for 2006-2007" at http:// www.aafp.org/x33958.xml.

For the most updated information on issues related to influenza, please visit http://www.cdc.gov/flu.
Hepatitis A Vaccine (Hep A) Hepatitis A** vaccine is now universally recommended for ALL
children at age 1 year (12 through 23 months of age). The two doses in the series should be administered at least six
months apart. For more information, please visit http://www.cdc.gov/
nip/recs/provisional_recs/hepA_child.pdf.
* Continuing education credits are offered for reviewing many of the Morbidity and Mortality Weekly Report (MMWR) reports. These available activities can be found at: http://www2a.cdc.gov/ce/ AvailableActivities.asp.
** Provisional recommendations of the ACIP become recommendations of the Centers for Disease Control and Prevention (CDC) once they are accepted by the Director of the CDC and the Secretary of Health and Human Services and are published in the MMWR. A listing of provisional and newly approved final recommendations can be found at http://www.cdc.gov/nip/recs/provisional_ recs/default.htm.

Resources

Save The Date
Save the Date for the 13th Annual Immunize Georgia Conference to be held on Tuesday, September 12, 2006 at the Georgia International Convention Center. Contact Angie Matthiessen with any questions at 404.785-7225 or angie.matthiessen@choa.org.

Georgia Immunization Program DHR's Georgia Immunization Program offers many resources to help with the daily needs of providing immunizations. Many of these resources can be accessed by visiting the Georgia Immunization Program Website at http://health.state.ga.us/programs/ immunization/index.asp. A "Request for Immunization Form" can be found under Health Care Provider Resources. Be sure to order Personal Immunization Records for your patients in English and Spanish. The Educational Training Presentations section will provide a complete listing of educational offerings for healthcare, school and day care providers, which are free of charge and done on site at your facility.
IAC Express Email Updates For comprehensive weekly updates on immunizations, visit www.immunize.org and sign up for the IAC Express. Vaccine Information Statements in many languages are available on this site.
Pandemic Influenza Resources at your fingertips At the 40th National Immunization Conference of the CDC, many sessions covered either influenza or planning for a pandemic.

Based on interviews with healthcare professionals and members of the general public, Alan Janssen with the National Immunization Program pointed out several key messages from the interviews that were effective for pandemic influenza messaging: Use the terms "bird flu" and "pandemic influenza." Avoid the term "priority groups." Provide small amounts of information at a time. Explain why preparations should be made now. Develop a communication plan (i.e. e-mail blasts). Teach families the difference between seasonal influenza and
pandemic influenza. Provide families with information on how to develop a home
protection plan.
The United States Department of Health and Human Services has developed communication tools for providing a consistent message to the public. Visit www.pandemicflu.gov frequently. Go to the Risk Communication Section under Resources to view the "Message Maps," which provide easily understood messages for the public. This site also provides comprehensive planning checklists.

Immunize Georgia / 2006 / VOL. 1 3

Walt Orenstein Champion for Immunization Awards

Five awards were presented at the 12th Annual IGLG Conference

to individuals and agencies that have succeeded in a variety of

areas--a school system, an immunization clerk, a Board of Health

employee and two practices with comprehensive usage of GRITS. As

evidenced by the excellent immunization coverage rates in Georgia,

similar initiatives are happening all across the state. Thank you for

The award nomination form for the 13th Annual Immunize

your hard work in protecting families and children from vaccine preventable diseases. Listed below is a brief highlight of the award recipients.

Georgia Conference is included with this newsletter. Please consider nominating an individual or group for a Walt Orenstein Champions for Immunization Award.

Prior to the 2003-2004 Influenza season, Wanda Jallow pictured below developing a successful campaign called "Service with a Smile" to increase influenza vaccination rates among DeKalb County Board of Health employees. Jallow took a rolling cart to departments and provided incentives (promotional items already in house) for employees. Influenza

vaccination rates among employees increased from

50 percent in 2003 to 63 percent in 2004.

The Kids' Clinic of Gwinnett Hospital System was one of the first to be trained in GRITS in April 2003. With almost 24,000 patient visits in 2004, 17,098 vaccinations were given to 4,023 clients, which is an average of about 328 shots being entered each week. The Kids' Clinic also maintains and reconciles their inventories through GRITS.
Kids' Clinic accepts the Walt Orenstein Award
For the Student Health Services of the DeKalb County School System, immunization compliance rates grew from 68 percent in 2002 to 82 percent in 2004. Glen Haven Elementary School had a "Back to School Rally," where the staff passed out flyers in the community to encourage parents to immunize their children. Another school displayed names of children who were up-to-date with their vaccinations with stars around the classroom. Each class that had 100 percent was recognized and honored.

Wanda Jallow accepts the Walt Orenstein Award

Through combining a health plan and state interventions, Kaiser Permanente Georgia (KPG) collaborated with GRITS to "Immunize Georgia's Adolescents." In 2004, these efforts helped raise KPG's adolescent immunization rates to 77 percent, compared to 59 percent, the national HEDIS average. Practitioners and providers at all points of access (i.e., dermatology, dentistry, emergency departments) used GRITS to identify needed immunizations, and then either gave the adolescent the shots or helped them make an appointment to receive the shots.

DeKalb County School System accepts the Walt Orenstein Award
As the Gilmer County Health Department Immunization Clerk and Certified Interpreter, Irene Rosales (not pictured) approaches her job as a mission. Rosales coordinated Immunization Week activities, getting local businesses involved to donate toys, food and money. She chose a theme for the festivities, decorated the waiting area and a bulletin board and had the staff dress up in keeping with the theme.

KPG accepts the Walt Orenstein Award Immunize Georgia / 2006 / VOL. 1 4

GRITS

Champion

GRITS STATS 5 million clients,
48 million immunization records,
3,000 partners

duplication." Or as Elayne Huntone, LPN, puts it: "How did we ever live without GRITS?"

Eastman Pediatrics' Founder, Dr. Johnny Peeples, has been a pediatrician for over 15 years. Since July 1990, Eastman Pediatrics has grown to include four physicians, a physician assistant, four full-time nurses, two part-time nurses and one medical assistant. In 2004, Eastman Pediatrics experienced a 14 percent growth, and the practice's patient load consisted of 12,800 doctor visits.
Eastman Pediatrics has not looked back since logging onto the Georgia Registry for Immunization Transactions and Services (GRITS) on March 1, 2004. DeCarla Morgan, RN and Kristi Dix, RN attended the one-day training on GRITS, which was conducted by Immunization Program Consultant, Clay Coleman. Morgan remembers her first impression of GRITS and the use of the computer. "I was scared to death of attending the GRITS training, so Kristi Dix attended, too, because of her computer knowledge," Morgan said. "We were all apprehensive but GRITS has helped us," Dix said. "GRITS is very, very smart and easy to use," added Dix.

"We applaud Dr. Peeples and the entire Eastman Pediatrics staff," said Thomas Moss, GRITS Immunization Manager. "They are using GRITS as it was intended and are helping us track and record immunizations on a statewide level. Our partners assist us in reaching our goal to assure that all persons in Georgia receive appropriate, timely immunizations to lead healthy, disease-free lives."
Eastman Pediatrics has entered 2,406 clients and 26,585 immunizations into GRITS. Immunize Georgia and the GRITS staff would like to acknowledge the dedication and hard work of their staff including Dr. Roman Gavino, Dr. Gwendolyn Gavino, Dr. Geraldine Gatmaitan, Ms. Deananne Fordham and Ms. Elizabeth Peeples, RN.
*Recommendations and exceptions can be found at www.cdc.gov/ nip/acip, www.aap.org or at www.aafp.org.
This article was written by Connie F. Smith, Program Information and Marketing Coordinator, Georgia Immunization Program.

"Dr. Peeples is committed to strengthening and improving his

care of patients," Morgan added. Beverly Perdue, LPN used

GRITS recently to show that GRITS can help providers eliminate

unnecessary immunizations, as well as emphasize the importance

of centralized data. During a routine visit, a guardian brought in

a four-year old patient and advised Eastman Pediatrics that the

child needed the DTaP immunization. The mother was not present

to answer some of the questions. Several healthcare providers

at various locations had seen the four-year old child. "The child

had received six DTaP vaccines in the first seven months of life,"

L-R: Beverly Perdue, LPN; Elizabeth Peeples, RN; Elayne Huntone, LPN; DeCarla Morgan, RN; and Kristi Dix, RN

Perdue reported. According to the current recommendations*,

five doses of DTaP are needed by the age of five years. "GRITS

cuts out the margin of error" of under or over immunization, Perdue added.

At the 12th Annual IGLG Conference, a panel was held on GRITS. Providers from across Georgia discussed how GRITS has helped make

Utilizing GRITS can assist providers in correctly assessing immunization needs. "If we had not been using GRITS when the four-year old patient was brought to our care, we would have relied on the guardian's word," Morgan said. "But we accessed GRITS and that patient received only the MMR immunization. Without a doubt, GRITS eliminates vaccine wastage and

the process of providing immunizations to Georgia's children more efficient. Questions were written by conference attendees, but not all were answered. These questions and answers are now posted on the Immunization Program Website, under "Immunization News" at http://health.state.ga.us/programs/immunization/index.asp. For questions on how to become a GRITS partner or how to use any of the GRITS features, please contact the GRITS Help Desk at

5

Immunize Georgia / 2006 / VOL. 1

888-223-8644.

2005 Survey Results

Thank you for completing the 2005 Newsletter Survey. Your feedback helps Immunize Georgia know what information is needed and how we can be a better resource to you. Ninety-nine percent of respondents felt the newsletter provides current information in a user-friendly format and ninety-five percent reported the newsletter makes it easier for them to stay up to date. Eighty percent reported they pass the newsletter on to someone else to read. Listed below are some creative ways providers have used the newsletter: Mail newsletter to all practices not currently using GRITS. Send emails to the staff to keep them informed. Share information in staff meetings and in talking with parents. Use in parent packets and in waiting/patient rooms. Give to the skeptic. Send "Parent Pages" to parents along with shots their child is missing. Copy the "Parent Pages" and put in the teacher's mail box. Post information for teachers in bathrooms and lounge. Make copies for the registrars at each school.
We Have a Winner! A drawing was held for those who sent their surveys in by a certain date. Congratulations to Claire Browning, RN and Lavista Medical Group, who received a FREE registration to the 13th Annual Immunize Georgia Conference.
Visit www.choa.org/immunization to access previous Volumes of the Immunize Georgia newsletter and the Take 5 for Teens Brochure.
2006 Children's Healthcare of Atlanta/CHDA919036 jt03.06 DPH06/065HW

ImmunGizeeorgia
Published by Children's Healthcare of Atlanta 1655 Tullie Circle NE, Atlanta, Georgia 30329-2321
Children's Healthcare of Atlanta 404-250-kids, www.choa.org
Immunize Georgia Angie Matthiessen, M.S.W. 404-785-7225, fax 404-785-7258 angie.matthiessen@choa.org
Georgia Immunization Program Ruth Gilmore, B.S.N. 404-657-3158, fax 404-657-1463 http://health.state.ga.us/programs/immunization/
Vaccines For Children Program 404-657-5013, fax 404-657-5736 800-848-3868, fax 800-372-3627
American Academy of Family Physicians Georgia Chapter 404-321-7445, www.gafp.org
American Academy of Pediatrics Georgia Chapter 404-876-7535, www.gaaap.org
CDC-INFO Contact Center 800-232-4636, www.cdc.gov/nip
CDC Spanish-Language Hotline 800-232-4636, www.cdc.gov/spanish/

Children's Healthcare of Atlanta Community Health Development and Advocacy 1655 Tullie Circle Atlanta, Georgia 30329-2321

Please route to:
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Parent Pages / Immunize Georgia / 2006 / VOL. 1
ParentPages SHOTSMARTS FROM IMMUNIZE GEORGIA

Protecting Your Family - Shots Are Not Just for Babies

Vaccines are not just for babies anymore. Preventing diseases now has a wider focus which includes adolescents, young adults and adults.

As caregivers and household members, pertussis (whooping cough) Meningococcal Conjugate Vaccine (MCV4) was approved by the

can be passed on to infants and young children who may not be fully FDA in January 2005.

protected. Pertussis in infants can be deadly. Protecting adolescents

All children age 11 to 12 years old should receive the vaccine,

and adults has the ultimate outcome of protecting the child. On the

as well as adolescents who have not received it who are entering

other hand, young children can spread diseases such as influenza,

high school.

hepatitis A and varicella to adolescents, young adults or the elderly. All college freshmen living in dormitories should also be vaccinated

with MCV4 or meningococcal polysaccharide vaccine (MPSV4).

Since early 2005, several new vaccines (shots) have been approved to

protect your family. Changes and additions have been made to both Two new vaccines are now available to protect against pertussis.

the Recommended Childhood and Adolescent Immunization Schedule Adolescents (11 to 12 years of age) should receive a single dose

and the Recommended Adult Immunization Schedule.

of Tdap vaccine in place of the tetanus (Td) booster.

Adolescents (13 through 18 years of age) who missed the Td

For specific information on vaccines for children, adolescents and

booster at 11 to 12 years of age should receive a single dose

adults, please visit http://www.vaccineinformation.org/.

of Tdap.

Be sure to ask your doctor about these recent changes which

Adults (19 through 64 years of age) who have or anticipate having

are discussed below:

close contact with an infant should receive a single dose of Tdap.

Pregnant women should receive a dose of Tdap in the immediate

Hepatitis A* vaccine is now recom-

postpartum period if they have not received Tdap previously.

mended for all children at age 1 year

(12 through 23 months). The two doses in Efforts to protect families from influenza will be changing for the

the series should be given at least six

2006-2007 flu season. All children 6 through 59 months of age and

months apart.

their family members or caregivers should now be vaccinated against

influenza each year.

Preventing hepatitis B infection

involves testing all pregnant

To learn more about protecting your family from influenza, please go

women at each pregnancy

to http://www.cdc.gov/flu/groups.htm. For more information

for hepatitis B during an early

on the differences between the seasonal influenza and an influenza

prenatal visit and/or testing

pandemic, please visit http://www.pandemicflu.gov/. To learn

women upon admission to

more about preparing your family for an influenza pandemic, click on

labor and delivery. Additional

the "Individual Planning" section of this Website.

recommendations include:

All newborns should receive

*These recommendations are provisional and will become final

the hepatitis B vaccine before once they are accepted by the Director of the Centers for Disease Control

hospital discharge.

and Prevention and the Secretary of Health and Human Services and are

All previously unvaccinated

published in the Morbidity and Mortality Weekly Report (MMWR).

children and adolescents under

19 years of age should receive

hepatitis B vaccine.

2006 Children's Healthcare of Atlanta/CHDA919036 jt03.06 DPH06/065HW

Parent Pages are intended to be copied and distributed to parents.

www.choa.org 404-250-kids www.health.state.ga.us/programs/immunization/

Parent Pages / Immunize Georgia / 2006 / Vol.1

Pertussis Spreads from Adolescents and Adults to Infants and Young Children

Did you know you are at risk to catch pertussis (whooping cough) and that you can spread it to infants and other members of your household? Did you know that infants (babies) can die from pertussis all from just a cough?
Lynne and Phil Baker know. Their son, Nelyn Frend-Theodore Baker was born healthy on April 7, 2004. Nelyn died of pertussis on April 25, 2004. Two weeks before Nelyn was born, Lynne was working at her job at a bookstore when a man coughed on her. She remembers thinking, "Great, by the time I have this baby, I am going to be sick."
The day she went into labor, the cough began and rapidly worsened. She went to the doctor twice within Nelyn's first two weeks. A chest X-ray showed nothing, and she felt well between coughing spells. Her doctor suggested that her condition could be related to a drug she had taken to stop contractions in the last months of her pregnancy. She was given antibiotics at the second visit.
Four days later, Nelyn became fussy, listless and started coughing. When Phil and Lynne took him to the doctor the next morning, he turned blue and was rushed to the hospital in an ambulance. When he died, his cause of death was listed as pneumonia. It was not until 10 days later that the Fulton County Health Department contacted the Bakers with the news that hospital tests showed Nelyn had died from pertussis.
In the days following Nelyn's death, family surrounded the Baker household, and then everyone traveled by car from Atlanta, Ga., to Michigan for the burial of Nelyn's ashes. During this time, the Bakers' teenage son and daughter, as well as Lynne's mother and sister, all came down with respiratory problems. In all, seven family members became sick. Lynne's sister, Julie, experienced months of problems, including long coughing fits and being unable to take a deep breath. When she went to the Emergency Room because her hands and feet were turning blue, she told the doctor about her nephew dying from pertussis. The doctors did not believe Julie. The Baker teenagers were taken out of school for a week. The school nurse told their mother, she did not believe it either, because, in her view, healthy people did not get pertussis.
In telling the story, Nelyn's short, sweet life can make a difference. Let this be a wake-up call for all of us to take action and raise awareness that pertussis is out there. Its effects are deadly and there are ways to prevent and identify pertussis.

Pertussis is on the rise In 1976, a total of 1,000 cases of pertussis were reported,
compared to 25,827 cases in 20041. One study suggests as many as 800,000 to one million
cases of pertussis are occurring each year many of which are never diagnosed as pertussis2.
Adolescents and adults can get pertussis In 2004, 34 percent of the reported pertussis cases were
in adolescents and 24 percent were in adults.3 In adolescents or adults, symptoms can be mild to severe. Pertussis can be spread before symptoms begin and can
still be spread for up to two weeks after coughing begins.2
Adolescents and adults spread pertussis to infants Adolescents and adults can pass pertussis to infants who
are too young to be completely vaccinated against it (younger than 6 months old). Between 1997 and 2000, 63 percent of infants under 6 months of age with pertussis were admitted to the hospital. Ninety percent of the deaths from pertussis were in infants.4
New vaccines to protect against pertussis Two new vaccines (Tdap) are now available to protect adolescents and adults from tetanus, diphtheria AND pertussis. See opposite page for details.
TAKE ACTION If you have a young infant in the house, talk to your doctor
about getting the Tdap vaccine yourself. If you have severe coughing for a week or more, talk to
your doctor about pertussis. Be sure young children complete the DTaP vaccine series
on time. Make sure your adolescent receives a health check before
middle school and high school to identify vaccines needed.
For more information, please visit www.pertussis.com.
1 Centers for Disease Control and Prevention. Epidemiology and Prevention of Vaccine-Preventable Diseases. Atkinson W, Hamborsky J, McIntyre L, Wolfe S, eds. 9th ed. Washington, DC: Public Health Foundation, 2006. 2 "Pertussis, moving from the young to preteens." Infectious Diseases in Children. February 2006. 3 "Pertussis vaccines seek to limit spread from adults and adolescents to infants." Infectious Diseases in Children. March 2006. 4 Immunization Action Coalition. Unprotected People - Report # 76.
June 23, 2005. www.immunize.org.

2006 Children's Healthcare of Atlanta/CHDA919036 jt03/06 DPH06/065HW Parent Pages are intended to be copied and distributed to parents. www.choa.org 404-250-kids www.health.state.ga.us/programs/immunization/