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Story from the Field

Name of Health Department/Agency: Maine Department of Health
State: ME
Date Added: 11/20/2009
Themes: Communications - Priority Groups,Vaccine Planning and Administration
Issue Summary: OB-GYNs outreach to pregnant women in Maine
Description of Issue(s): Reaching priority group of pregnant women to encourage vaccination through all OB-GYN doctors, midwives, and other health care providers listed on a birth certificate in Maine.
Actions taken to address the issue(s): •We started in early September.  We sent a letter out to every health care provider who is listed on a birth certificate in Maine.  We didn’t want to just reach OB practices because then they would get one letter per practice with five obstetricians and two midwives and somebody would open it and who knows where it would end up but probably something like the circular file.  So we picked the names of all the health providers on birth certificates.  If a practice had 5 OBs and two midwives, they would get seven letters to each of the health care providers so hopefully that would reach them more individually. 
•We sent the same letter out to our health care alert network as well.  We had a vaccine coordinator for each district in the state.  We asked them also to help us reach out to obstetricians, midwives, and nurse practitioners who take care of pregnant women.   
•So then we recruited them in that letter to convince them that vaccinating was a good thing but also to recruit them to register as vaccine providers for H1N1 vaccine.  As we got the registrations in throughout the month of September, we then went through the list and compared it to the list that we had mailed the recruitment letters to and we found that there were gaps.  So when we found there were gaps—that is obstetricians or other health care providers for pregnant women who hadn’t signed up we actually contacted them either by having one of the vaccine coordinators in the field call them or myself or my maternal-child health medical director call them. 
•Very often the person whom we had call them--and I think this was key--was the ACOG (American College of Obstetricians and Gynecologists) main chapter president.  He is an OB-GYN who was fabulous and has felt very strongly about the importance of vaccinating for influenza for pregnant women.  So he personally made a number of contacts with obstetricians who were reluctant to offer vaccine. Leveraging their own leadership was a very important key.
•Once we got the injectable vaccine that was appropriate for them, we did distribute vaccine to them. We tried to saturate the obstetricians’ offices and other health care providers that take care of pregnant women with vaccine as early and as quickly as we could.
•We also put an ad on TV.  We have a PSA that I had filmed back in October targeting pregnant women that’s on air now.  It’s also kind of an ad about the safety of the vaccine. We know right know that our demand is so high and is so outstripping our supply that we don’t dare put out an ad asking other people to get the vaccine.  But we thought that where we knew we had enough vaccine for pregnant women, we’ve run the ad quite a bit.  It also talks about the fact that it’s licensed by FDA just as any other influenza vaccine is and kind of addresses some of the safety issues that we think other people who aren’t pregnant may have those questions as well.  The ad specifically targets pregnant women and how important it is for them to get vaccinated. 
Outcomes that resulted from actions taken: •So, that summarizes our strategies of doing direct outreach to every practitioner that takes care of pregnant women, leveraging their own leadership to reach out to those providers who are reluctant, and using our own leadership as well.  Then following up with an ad once we got the vaccine which we had a pretty heavy buy on and TV and radio this last three weeks.
•That’s it from Maine.  So far we’ve had pretty good uptake but we’ll know when the numbers roll in.

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