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MNAAP Newsletter

Lessons Learned on Increasing MMR Vaccines During the Outbreak

By Anne Valaas-Turner, MD, FAAP

On August 25, 2017, the Minnesota Department of Health declared an end to the measles outbreak…. along with a collective, statewide sigh of relief. As part of this announcement, Commissioner of Health Dr. Ed Ehlinger thanked all of the health systems, hospitals, clinics, doctors, pediatric clinicians, clinic staff and local public health who worked so hard to contain the Spring epidemic. He also highlighted the Allina Health System, which according to MDH records, provided the most MMR vaccine during the outbreak.

Pediatric staff reflected on this news and identified several key beliefs and lessons that we learned.

Communications: We were immediately notified of the measles outbreak by the MDH vaccine preventable disease listserv. Lesson: It may be useful to include “helpful e-mail lists to join” as part of the onboarding process for new providers.
Team structure: As a pediatrician, I share work space with my assistant, two partners, and their assistants. It was easy to teach the team the new vaccine recommendation, since we all work together in the same space. I will begrudgingly admit that the daily huddle system I sometimes rail against allowed for communication up and down the leadership structure about our measles response. We also got regular updates about the number of MMR doses in clinic, which was helpful.

Relationships: I truly believe that the time spent on rapport multiplies long-term health benefits, and I am grateful to Allina for the time to tend relationships. As a med-peds physician, I know the entire family, and could recommend MMR vaccination for young family members even if they were not present. I’ve partnered with the same medical assistant for the past 8 years, so she knows my families as well as I do, and was also able to catch kiddos in much the same way. Lesson: I’m grateful to my clinic leadership for valuing our collaboration enough to keep us together even through maternity leaves and FTE mismatches.

The power of yes: We immunized any eligible child present in clinic at any opportunity. Sick visit, well visit, sibling tagalong, seen in the lobby while parent is picking up forms…. we vaccinated them all. Our medical assistants and reception staff bore the brunt of adding on extra nurse-only visits, and my gratitude goes to them for just saying yes. Lesson: Say yes during outbreaks

A powerful electronic medical record: Once our vaccine supply was adequate, Allina generated lists of children eligible for MMR who had not yet received it, and notified their parents. This valuable work was appropriately performed at the organizational level, freeing my assistant up to deliver vaccine. We are strong advocates of vaccination and have wide access to the population of patients resisting vaccine.

We are proud of our work in the outbreak and would love to be part of the solution to preventing future outbreaks.


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