BACKGROUND: Close-contact populations, such as those found at residential higher education campuses, are at higher risk of communicable disease transmission and pose unique challenges for vaccine-preventable disease surveillance and outbreak investigations. As such, robust immunization coverage, appropriate tracking of immunization records, prompt disease reporting, and strong relationships with local health partners are critical in these populations. Indiana’s higher education code (IC 21-40-5) and communicable disease rule (410 IAC 1-2.3) delineate some immunization-related and disease reporting requirements for higher educational institutions; however, there is still significant variability among institutions in their immunization and reporting practices.
METHODS: Higher-education institutions in Indiana were identified and institutions were included if they had an independent student health center (SHC) that served a residential population. A phone survey was administered during September 2015 to each institution including information about current policies and practices regarding immunization documentation, immunization administration and vaccine availability, awareness about the state immunization registry (CHIRP), awareness of state disease alert systems, and familiarity or use of the Indiana National Electronic Disease Surveillance System (I-NEDSS) for disease reporting.
RESULTS: Phone surveys were completed for 33 of 38 (86.8%) universities. Of SHCs interviewed, 73.5% reported that immunization records were entered into an accessible electronic system either by the SHC or the registrar. 82.0% of SHCs reported stocking and offering at least one vaccine to clients. Most SHCs (61.8%) reported using CHIRP to access records, but only 17.6% reported entering new records into CHIRP. Effective July 2015, all Indiana vaccine providers were mandated to enter records into CHIRP when administering doses to persons under 19 years of age, however, only 17.6% of SHCs reported being aware of this regulation. SHCs had low overall subscription to state alerting systems - Indiana Health Alert Network (21.2%) and Indiana State Department of Health Epidemiology Resource Center Weekly Digest (12.2%) - and low use of I-NEDSS (9.1%). However, approximately 80% of SHCs reported that they would like to use all three services.
CONCLUSIONS: Preparedness of residential higher-education campuses to respond to vaccine-preventable disease threats is directly impacted by accessibility of records and understanding of reporting and immunization policies. Next steps include engaging SHCs to address the needs identified in this survey and provide services pertinent to disease investigation. Improving mutual understanding of policy and practice between state health departments and residential higher-education campuses could increase the ability for both parties to respond promptly and appropriately to public health challenges.