CE Credit

Immunization

Welcome to the training on Immunization provided by the Texas Health and Human Services Commission (HHSC) and the Texas Department of State Health Services (DSHS).

Credit hours: 1.50 CE

  • Overview
  • Appendix
  • References

Goal

The goal of this module is to equip Texas Health Steps providers and other interested health-care professionals to apply the CDC Advisory Committee on Immunization Practices (ACIP) immunization schedules and recommendations, counsel parents about immunizations, and employ best practices for vaccine administration, storage and handling, and reporting.

Target Audience

Texas Health Steps providers and other interested health-care professionals.

Specific Learning Objectives

After completing the activities of this module, you will be able to:

  1. Apply the CDC Advisory Committee on Immunization Practices (ACIP) recommended routine and catch-up immunization schedules for children and adolescents.
  2. Assess effective strategies for counseling parents about the importance of vaccinating their children.
  3. Specify precautions and contraindications that affect administration of vaccines.
  4. Summarize appropriate administration routes and techniques to use when vaccinating children and adolescents.
  5. Employ proper procedures for the safe storage and handling of vaccines.
  6. Employ the features of the Texas Immunization Registry (ImmTrac2) to improve delivery of immunizations and meet legal reporting requirements.

Please note this module expires on 4/3/2023.

This module was released on 4/3/2020.

  • Resources

Section 1: Overview of the Benefits of Immunization and the CC Advisory Committee on Immunization Practices (ACIP) Schedule

  • American Academy of Family Physicians, Practice Guidelines. (2019) ACIP Approves 2019 Adult and Childhood/Adolescent Immunization Schedules.
  • American Academy of Pediatrics. Committee on Infectious Diseases, Policy Statement. (2019) Recommended Childhood and Adolescent Immunization Schedules: United States, 2019.
  • American College of Obstetricians and Gynecologists. ACOG Departments & Activities. Immunization webpage.
  • Centers for Disease Control and Prevention. (2020) Advisory Committee on Immunization Practices (ACIP).
  • Centers for Disease Control and Prevention. (2019) Human Papillomavirus (HPV. Genital HPV Infection – Fact Sheet.
  • Centers for Disease Control and Prevention. (2019) Human Papillomavirus (HPV). HPV and Men – Fact Sheet.
  • Centers for Disease Control and Prevention. (2019) Immunization Schedules.
  • Centers for Disease Control and Prevention. (2019) Immunization Schedules. Childhood Vaccine Assessment Tool webpage is for parents. Parents can answer a few simple questions (which is not collected or stored) to receive a complete list of recommended immunizations.
  • Centers for Disease Control and Prevention. (2019) Immunization Schedules. Table 1. Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger, United States, 2019.
  • Centers for Disease Control and Prevention. (2019) Immunization Schedules webpage with parent-friendly formats of vaccine schedules.
  • Centers for Disease Control and Prevention. (2018). Infographic: The Journey of Your Child's Vaccine.
  • Centers for Disease Control and Prevention. (2016). Vaccines for Children Program (VFC)
  • Centers for Disease Control and Prevention. (2019) Vaccines for Your Children. Why Vaccinate?
  • Centers for Disease Control and Prevention. (2019) Vaccine Information Statement for HPV Vaccine: What You Need to Know.
  • Centers for Disease Control and Prevention. (2019) Vaccine Recommendations and Guidelines of the ACIP. Influenza ACIP Vaccine Recommendations.
  • Centers for Disease Control and Prevention. (2015) Vaccine Safety. Influenza (Flu) Vaccines.
  • National Institutes of Health, National Cancer Institute. (2019) Human Papillomavirus (HPV) Vaccines.
  • Texas Health and Human Services, Texas Department of State Health Services. (2019) Immunization Unit.
  • Texas Health and Human Services, Texas Department of State Health Services. (2019). National Immunization Survey (NIS)–Child (NIS-Child) 2017.
  • Texas Health and Human Services, Texas Department of State Health Services. (2019). National Immunization Survey-Teen (NIS-Teen) 2018, Texas.
  • Texas Health and Human Services. Texas Department of State Health Services. (2019) Texas School and Child-Care Facility Immunization webpage.
  • WhyImmunizeKids.org, a partnership that includes the American Academy of Pediatrics. Parent and Family Resources. (Bilingual).

Section 2: Immunization Barriers and Solutions

  • American Academy of Pediatrics. Immunizations. Vaccine Hesitant Parents webpage. Accessed March 2020.
  • Children's Hospital of Philadelphia. Vaccine Education Center. YouTube. May 13, 2015. Talking About Vaccines with Dr. Paul Offit. Do Babies Get Too Many Vaccines?
  • Children's Hospital of Philadelphia. Vaccine Education Center. YouTube. May 13, 2015. Talking About Vaccines with Dr. Paul Offit. Do Vaccines Cause Autism?
  • Centers for Disease Control and Prevention. (2018) Advisory Committee on Immunization Practices (ACIP). Evidence-Based Recommendations—GRADE.
  • Centers for Disease Control and Prevention. Epidemiology and Prevention of Vaccine-Preventable Diseases. Epidemiology and Prevention of Vaccine-Preventable Diseases. The Pink Book: Course textbook – 13th Edition (2015 and 2017 supplement).
  • Centers for Disease Control and Prevention. (2019) Epidemiology and Prevention of Vaccine-Preventable Diseases. Immunization Strategies for Healthcare Practices and Providers webpage.
  • Centers for Disease Control and Prevention. (2018) Healthcare Providers/Professionals. Reminder Systems and Strategies for Increasing Childhood Vaccination Rates webpage.
  • Centers for Disease Control and Prevention. (2019) (IQIP) Immunization Quality
  • Improvement for Providers webpage.
  • Centers for Disease Control and Prevention. (2020) Measles (Rubeola) Measles Cases and Outbreaks.
  • Centers for Disease Control and Prevention. (2020) Mumps. Mumps Cases and Outbreaks.
  • Centers for Disease Control and Prevention. (2017) Pregnancy and Vaccination. Tdap (Pertussis) Vaccine and Pregnancy.
  • Centers for Disease Control and Prevention. (2018) Vaccine Safety. Multiple Vaccines and the Immune System webpage.
  • Centers for Disease Control and Prevention. (2015) Vaccine Safety. Vaccines Do Not Cause Autism webpage.
  • Centers for Disease Control and Prevention. (2016) Vaccines for your Children. Vaccine Resources for Parents.
  • Clarification to 'NCCI Changes to be Enforced for Vaccine Administration and Preventive Medicine E/M Visits Effective April 1, 2014' download.
  • Dallas County Department of Health and Human Services. Epidemiology. Health Update (2): Mumps. December 13, 2016. Accessed January 2020.
  • Generations United. Valuing Vaccinations Across Generations.
  • HealthyChildren.org, sponsored by the American Academy of Pediatrics. Immunizations: A large collection of articles about childhood vaccines and safety. (Bilingual).
  • Immunization Action Coalition. (2019) Handouts. Clinic Resources, Standing Orders for Administering Vaccines web page.
  • Immunization Action Coalition. (2019) Parent Handouts. (Multiple languages).
  • National Conference of State Legislatures. States with Religious and Philosophical Exemptions From School Immunization Requirements (2019).
  • Resources to help providers communicate with parents who may be hesitate about vaccines for their children:
  • Download the AAP's Countering Vaccine Hesitancy (2016) Clinical Report for a comprehensive examination of the reasons for vaccine hesitancy and information about addressing parental concerns about vaccination. An extensive list of resources is also provided.
  • Centers for Disease Control and Prevention. (2015) Provider Resources for Vaccine Conversations with Parents web page.
  • Visit the AAP Vaccine Hesitant Parents web page to learn more about parental attitudes about immunization, strategies for talking to parents, and immunization policies and resources for health-care providers.
  • A list of science-based materials to help you respond to vaccine-hesitant parents can also be downloaded from the website of the Immunization Action Coalition, a national nonprofit dedicated to immunization education.
  • Texas Health and Human Services. Texas Department of State Health Services. (2019) Immunization Information for Parents and the Public webpage.
  • Texas Health and Human Services, Texas Department of State Health Services. (2019). Information for Providers – Texas Vaccines for Children.
  • Texas Health and Human Services, Texas Department of State Health Services. (2019) Measles.
  • Texas Health and Human Services, Texas Department of State Health Services. (2019) Measles 2019.
  • Texas Health and Human Services, Texas Department of State Health Services. (2019) Mumps.
  • Texas Health and Human Services, Texas Department of State Health Services. (2019) Pertussis Data.
  • Texas Health and Human Services, Texas Department of State Health Services. (2019).Texas Vaccines for Children Program – Immunizations Unit.
  • Texas Family Code, Section 32.1011 of Subchapter B, Chapter 32, defines specific circumstances when teenage parents can legally consent to their own immunizations.
  • Texas Family Codes Chapter 151, 153, Chapter 32 §32.002, and Chapter 32 §32.102, and Texas Administrative Code, Title 25, Part 1, Chapter 97, Subchapter C state the requirements that Texas Vaccine for Children providers must provide on the risks and benefits associated with each vaccine.
  • Texas Medicaid Provider Procedure Manual website.
  • Texas Vaccines for Children and Adult Safety Net manual. The manual provides educational and procedural information, including:
  • Vaccine ordering and accountability.
  • Vaccine storage and handling.
  • Immunizations: Guidelines and general recommendations.
  • Immunization Requirements: School laws.
  • ImmTrac2: Immunization tracking.
  • Forms and literature.
  • Vaccine Information Statements (VIS).
  • Vaccine Adverse Event Reporting System (VAERS).
  • Vaccine safety information.
  • Other resources.
  • The Dallas Morning News. Johnson County Mumps Outbreak is Worst Texas Has Seen in Years. December 5, 2016. Accessed January 2020.
  • The Texas Observer. In Texas, Three More Measles Cases and Four New Anti-Vaccine Bills. March 18, 2019. Accessed 2020.
  • The Texas Tribune. Texas Investigating Highly Contagious Whooping Cough at State Capitol. March 25, 2019. Accessed 2020.
  • The Texas Tribune. Texas Vaccine Exemption Rates: Look up Your District or Private School. August 13, 2019. Accessed January 2020.
  • U.S. Department of Health and Human Services. News Release: With End of New York Outbreak, United States Keeps Measles Elimination Status. HHS Press Office. October 4, 2019.
  • U.S. Department of Health & Human Services. Vaccines & Immunizations. National Vaccine Advisory Committee (NVAC).
  • U.S. Department of Health & Human Services. Vaccines & Immunizations. Reports & Recommendations.

Vaccine Resources

  • Information for health-care providers on the DSHS Immunization Branch home page.
  • The CDC's Education & Training for Health Professionals web page.
  • The CDC's Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book) web page containing the most recent edition (13th Edition 2015) and supplement (2017).
  • The AAP's Immunization website.
  • The Immunization Partnership website.
  • Immunization Action Coalition website.

Section 3: Admin
istration Contraindications and Precautions

  • Centers for Disease Control and Prevention. Epidemiology and Prevention of Vaccine Preventable Diseases (The Pink Book, CDC 2015), Appendix A: Schedules and Recommendations download detailing recommendations for immunizing people with primary and secondary immune deficiencies (2018).
  • Centers for Disease Control and Prevention. Epidemiology and Prevention of Vaccine Preventable Diseases (The Pink Book, CDC 2015), Appendix D: Vaccine Safety. The Vaccine Adverse Event Reporting System (VAERS) (2017).
  • Centers for Disease Control and Prevention. (2019) Vaccine Information Statements (VISs) webpage.
  • Centers for Disease Control and Prevention. (2020) Vaccine Information Statements (VISs). Current VISs webpage.
  • Centers for Disease Control and Prevention. (2019) Vaccine Information Statements (VISs) Instructions for Using VISs webpage.
  • Centers for Disease Control and Prevention. (2019) Vaccine Recommendations and Guidelines of the ACIP. Contraindications and Precautions webpage.
  • Centers for Disease Control and Prevention. (2020) Vaccine Safety webpage.
  • Infectious Diseases Society of America (IDSA) guidelines (2013) for vaccinations of immunocompromised patients webpage. Clinical Practice Guideline for Vaccination of the Immunocompromised Host and related corrections to the guidelines.
  • Texas Health and Human Services. Texas Department of State Health Services. (2019) Immunization Literature & Forms webpage containing online order form for immunization related publications.
  • Texas Health and Human Services. Texas Department of State Health Services. (2020) Vaccine Information Statements (VIS) – Immunization Unit webpage.
  • The National Academies of Sciences Engineering Medicine. (2011) Health and Medicine Division. Adverse Effects of Vaccines: Evidence and Causality.
  • U.S. Department of Health and Human Services. Vaccine Adverse Event Reporting System (VAERS) webpage.

Section 4: Administration Techniques

  • California Department of Public Health. Immunization Branch. Immunization Site Map downloads:
    • Sample Infant Immunization Site Map (page 1)
    • Sample Toddler Immunization Site Map (page 2)
  • Centers for Disease Control and Prevention. Epidemiology and Prevention of Vaccine-Preventable Diseases. Epidemiology and Prevention of Vaccine-Preventable Diseases. The Pink Book: Course textbook – 13th Edition (2015 and 2017 supplement).
  • Centers for Disease Control and Prevention. (2019) Healthcare Providers/Professionals. Administer the Vaccine(s) webpage.
  • Centers for Disease Control and Prevention. (2019) Healthcare Providers/Professionals. Administer the Vaccine(s) download Administering Vaccines: Dose, Route, Site, and Needle Size.
  • Centers for Disease Control and Prevention. (2015) Vaccine Safety. Fainting (Syncope) webpage.
  • Centers for Disease Control and Prevention. (2018) Vaccine Safety. Multiple Vaccines and the Immune System webpage.
  • Centers for Disease Control and Prevention. (2019) Vaccines for Your Children. How to Hold Your Child During Vaccination webpage.
  • Centers for Disease Control and Prevention. (2019) Vaccines for Your Children. Make Shots Less Stressful webpage.
  • Texas Department of State Health Services. "Giving All the Doses" Poster Stock #11-12155 downlaod.
  • Texas Department of State Health Service. "How to Administer Injections" Poster Stock # 6-27P (available in English and Spanish) download.
  • Texas Health and Human Services. Texas Department of State Health Services. (2019) Immunization Literature & Forms webpage containing online order form for immunization related publications.

Section 5: Vaccine Storage and Handling

  • Andrew T. Kroger. Make No Mistake: Vaccine Administration, Storage, and Handling 6-minute video - Medscape - Jun 27, 2011.
  • Centers for Disease Control and Prevention offers extensive online training for proper vaccine storage and handling on its Vaccines & Immunizations Vaccine Storage and Handling web page. You Call the Shots is an interactive, web-based module of learning opportunities, self-test practice questions, reference and resource materials, and an extensive glossary.
  • Centers for Disease Control and Prevention. (2019) Vaccine Storage and Handling Toolkit offers detailed information about maintaining the safety and efficacy of vaccines.
  • Texas Health and Human Services. Texas Department of State Health Services. Vaccine Storage & Handling – Texas Vaccines for Children webpage.
  • Texas Vaccines for Children (TVFC) program offers a nine-chapter Storage & Handling video series to help health-care providers stay up to date on the latest standards for handling its vaccine supplies.
  • U.S. Department of Health and Human Services. Office of Inspector General. (2012) Vaccines for Children Program: Vulnerabilities in Vaccine Management report webpage.
  • Section 6: Using ImmTrac2 to Serve Texas Children and Adolescents
  • Texas Health and Human Services. Texas Department of State Health Services. (2020) Forms and Documents webpage provides forms, including consent forms and other documents useful for providers.
  • Texas Health and Human Services. Texas Department of State Health Services. (2020) ImmTrac2 Registry Home webpage.
  • Texas Family Code, Section 32.1011 of Subchapter B, Chapter 32, defines specific circumstances when teenage parents can legally consent to their own immunizations.
  • Texas Health and Safety Code 161.00735(h)(1)(2) lists the required items a provider administering a vaccine must record in a medical record. It also states that ImmTrac2 is allowed to share information with other states in case of emergency or disaster evacuation purposes.
  • To participate in ImmTrac2, access and complete the online ImmTrac2 Site Agreement. There is an online provider registration module on that website, and you may also contact the ImmTrac2 Customer Support line at 800-348-9158.
  • Featured
  • Definitions

The medical definitions provided in this module were adapted from the American Academy of Pediatrics, Centers for Disease Control and Prevention, the Free Dictionary, National Institute of Neurological Disorders and Stroke, and the U.S. National Library of Medicine.

  • Related courses