Appendix I - Virginia Commonwealth University · 2nd Floor Raleigh, NC 27609-3811 NORTH DAKOTA...

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APPENDIX I

Immunization Resources

National Immunization Program Contact Information . . . . . . . . . . . . . . I-1

IAC Online Directory of Immunization Resources . . . . . . . . . . . . . . . . . I-2

Sample IAC Print Materials. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I-3

IAC Express Information Sheet. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I-4

“Immunization Techniques” Video Order Form. . . . . . . . . . . . . . . . . . . . I-5

Global Vaccination Information Websites. . . . . . . . . . . . . . . . . . . . . . . . . I-6

State and Local Immunization Grantee Contact Information . . . . . . . . . I-7

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Centers for Disease Control and Preventionand

National Immunization Program

Contact Information & Resources

TelephoneImmunization Call Center800-232-4636 (800-CDC-INFO)

Contact CDC-INFO 24 hours a day, 7 days a week, in English or Spanish, with questionsconcerning immunizations or vaccine-preventable diseases, or to find the location of

immunization clinics near you, or to order single copies of immunization materials from NIP.

E-Mailnipinfo@cdc.gov

Healthcare providers can send their immunization or vaccine-preventable disease relatedquestions to this e-mail address. You will get an answer from a National Immunization Program

expert, usually within 24 hours.

InternetNIP: http://www.cdc.gov/nip

Hepatitis: http://www.cdc.gov/hepatitisInfluenza: http://www.cdc.gov/flu

Travelers’ Health: http://www.cdc.gov/travelCalendar of upcoming events, online access to publications such as ACIP statements and VaccineInformation Statements, online publications ordering, vaccine safety information, latest pediatric

and adult immunization schedules, downloadable Clinic Assessment Software Application(CASA), Frequently Asked Questions, PowerPoint slide presentations from the Pink Book and

from NIP satellite broadcasts, links to other immunization sites, and much more.

NIP Training & Education Resources. Download NIP’s curriculum brochure:http://www.cdc.gov/nip/ed/curriculum/curric-brochure.htm

Publications may be ordered through NIP’s online order form:http://www.cdc.gov/nip/publications

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Sample IAC Print MaterialsThese, and many other useful materials for both providers and patients, can be downloaded

free of charge from the IAC’s website at http://www.immunize.org/catg.d/free.htm

Vaccine AdministrationRecordfor Children and Teens

http://www.immunize.org/catg.d/p2022b.pdf

Standing Orders for AdministeringInfluenza Vaccine to Adults

http://www.immunize.org/catg.d/p3074.pdf

Screening Questionnairefor Child and Teen Immunization

http://www.immunize.org/catg.d/p4060scr.pdf

Are You 11-19 Years Old?http://www.immunize.org/catg.d/11teens8.pdf

Temperature Log for Vaccines (Fahrenheit)http://www.immunize.org/catg.d/p3039pdf

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Global Vaccination Information

Statistics and Graphics(http://www.who.int/immunization_monitoring/data/en/)

This page contains links to slides, maps, tables, and other documents relating toglobal and national disease incidence, vaccine coverage, and other immunization-related topics.

Global Summary “Country Profile Selection Centre”(http://www-nt.who.int/immunization_monitoring/en/globalsummary/countryprofileselect.cfm)

On this page the reader can view an “Immunization Profile” for a selected country,which includes information on population, disease incidence, vaccine coverage,and the routine schedule.

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NATIONAL IMMUNIZATION PROGRAMIMMUNIZATION GRANTEES

December 13, 2005

STATE & CITY GRANTEES

ALABAMAAlabama Department of Public Health PHONE #: (334) 206-5023State Immunization Program FAX #: (334) 206-2044P.O. Box 303017 Program Manager: Winkler SimsMontgomery, AL 36130-3017 Email: wsims@adph.state.al.usFed Ex: Disease Control/Immunization Div.The RSA Tower201 Monroe St., Suite 1460Montgomery, AL 36104

ALASKAAlaska Department of Health and Social Services PHONE #: (907) 269-8000Immunization Program FAX #: (907) 562-78023601 C. Street, Suite 540 Program Manager: Laural H. WoodP.O. Box 240249 Email: laurel_wood@health.state.ak.usAnchorage, Alaska 99503

ARIZONAArizona Department of Health Services PHONE #: (602) 364-3630Immunization Program Office FAX #: (602)364-3276150 N. 18th Ave. Program Manager: Kathy FredricksonPhoenix, Arizona 85007-3233 Email: Fredrik@azdhs.gov

ARKANSASArkansas Department of Health PHONE #: (501) 661-2000Immunization Program FAX #: (501) 661-23004815 West Markham Program Manager: Charles BeetsSlot #48 Email: cbeets@healthyarkansas.comLittle Rock, Arkansas 72205-3867

CALIFORNIACalifornia Department of Health Svcs PHONE #: (510) 540-2065Immunization Branch FAX #: (510) 883-6015850 Marina Bay Parkway, Building P Program Manager: Howard BackerRichmond, California 94804-6403 Email: Hbacker@dhs.ca.gov

COLORADOColorado Department of Public Health & Environment PHONE #: (303) 692-2650PSD-IMM-A4 FAX #: (303) 691-61184300 Cherry Creek Dr., South Program Manager: Rebecca JordanDenver, Colorado 80246-1530 Email: rebecca.jordan@state.co.us

CONNECTICUTConnecticut State Dept of Public Health PHONE #: (860) 509-7929Immunization Program FAX #: (860) 509-7945P.O. Box 340308 ProgramManager: Vincent Sacco410 Capitol Avenue, MS# 11 MUN Email: vincent.sacco@po.state.ct.usHartford, Connecticut 06134-0308

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DELAWAREImmunization Program/Div of Public Health PHONE #: (302) 741-2940Delaware Dept of Health & Social Services FAX #: (302) 739-2358The Jessie Cooper Building ProgramManager: Martin LutaFederal & Water Street Email: martin.luta@state.de.usDover, Delaware 19901

FLORIDAFlorida Department of Health PHONE #: (850) 245-4342Bureau of Immunization FAX #: (850) 922-41954052 Bald Cypress Way, #A-11 Program Manager: Charles AlexanderTallahassee, Florida 32399-1719 Email: charles_alexander@doh.state.fl.usFed Ex: 2585 Merchants Row Blvd, Rm 210Prather Bldg, Suite 210Tallahassee, FL 32399-1719

GEORGIAGeorgia Department of Human Resources PHONE #: (404) 657-3158Division of Public Health FAX #: (404) 657-1463Two Peachtree Street, N.W., 15th Floor, Rm 470 Program Manager: Michael ChaneyAtlanta, Georgia 30303 Email: mechaney@dhr.state.ga.us

HAWAIIHawaii Department of Health PHONE #: (808) 586-8300Immunization Program FAX #: (808) 586-83021250 Punchbowl Street - Room 428 Program Manager: Malama MarkowitzP.O. Box 3378 Email: ralene.m.markowitz@doh.hawaii.govHonolulu, Hawaii 96801Fed Ex: 1250 Punchbowl St., Rm 428Honolulu, Hawaii 96813

IDAHOIdaho Department of Health and Welfare PHONE #: (208) 334-5931Immunization Program FAX #: (208) 334-49144th Floor, 450 West State Street Program Manager: Tricia Hosch-HebdonBoise, Idaho 83270 Email: hoscht@idhw.state.id.us

ILLINOISllinois Department of Public Health PHONE #: (217) 785-1455Immunization Program FAX #: (217) 524-0967525 West Jefferson Street Program Manager: Karen McMahonSpringfield, Illinois 62761 Email: Kmcmahon@idph.state.il.us

CHICAGOChicago Department of Health PHONE #: (312) 746-5380Immunization Program FAX #: (312) 746-6388Westside Center for Disease Control Program Manager: Maribel Chavez-Torres2160 West Ogden Avenue Email: Chavez-Torres_M@cdph.orgChicago, Illinois 60612

INDIANAIndiana State Department of Health PHONE #: (800) 701-0704Immunization Program FAX #: (317) 233-78052 North Meridian Street Program Manager: Carol BrileyIndianapolis, Indiana 46204-3003 Email: cbriley@isdh.IN.govs

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IOWAIowa Department of Public Health PHONE #: (515) 281-4923Division of Family/Community Health FAX #: (800) 831-6292321 E. 12th Street Program Manager: Don CallaghanDes Moines, Iowa 50319-0075 Email: dcallagh@idph.state.ia.us

KANSASKansas State Department of Health PHONE #: (785) 296-5591Bureau of Disease Prevention FAX #: (785) 296-6368900 S.W. Jackson Street Program Manager: Michael RunauL.S.O.B Suite 901 N Email: mrunau@kdhe.state.ks.usTopeka, Kansas 66612-1274

KENTUCKYKentucky Department for Public Health PHONE #: (502) 564-4478Immunization Program FAX #: (502) 564-4760275 East Main Street, HSIC-D Program Manager: David MillerFrankfort, Kentucky 40621-0001 Email:

LOUISIANALouisiana Office of Public Health PHONE #: (504) 838-5300Immunization Program - Suite 107 FAX #: (504) 483-19091450 L and A Road Program Manager: Ruben TapiaMetairie, Louisiana 70001 Email: RAT1017@yahoo.com

MAINEMaine Department of Human Services PHONE #: (207) 287-3746Immunization Program FAX #: (207) 287-81272 Bangor Street Program Manager: Jiancheng Huang11 State House Station Email: jiancheng.haung@maine.govAugusta, Maine 04333

MARYLANDMaryland Department of Health & Mental Hygiene PHONE #: (410) 767-6679Center for Immunization FAX #: (410) 333-5893201 West Preston Street, 3rd Floor Program Manager: Gregory ReedBaltimore, Maryland 21201 Email: reedgre@dhmh.state.md.us

MASSACHUSETTSMassachusetts State Lab Inst - CDC PHONE #: (617) 983-6800Division of Epidemiology & Immunization FAX #: (617) 983-6868305 South Street, Room 506B Program Manager: Pejman TalebianJamaica Plain, Massachusetts 02130-3597 Email: Pejman.Talebian@state.ma.us

MICHIGANMichigan Department of Community Health PHONE #: (517) 335-8159Division of Immunization FAX #: (517) 335-9855201 Townsend Street Program Manager: Bob SwansonP.O. Box 30195 Email: SwansonR@michigan.govLansing, Michigan 48909

MINNESOTAMinnesota Department of Health PHONE #: (612) 676-5100Immunization Program FAX #: (612) 676-5689625 N. Roberts Street Program Manager: Kristin EhressmannP.O. Box 64975 Email: Kristen.Ehresmann@health.state.mn.usSt. Paul, Minnesota 55164-0975

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MISSISSIPPIMississippi State Department of Health PHONE #: (601) 576-7751Division of Immunization FAX #: (601) 576-7686570 Woodrow Wilson Blvd Program Manager: Joy Sennett (acting)P.O. Box 1700 Email: jsennett@msdh.state.ms.usJackson, Mississippi 39215-1700

MISSOURIMissouri Department of Health PHONE #: (573) 751-6439Section of Vaccine-Preventable Diseases FAX #: (573) 526-6892930 Wildwood Drive Program Manager: Brad HallP.O. Box 570 Email: hallb@dhss.state.mo.usJefferson City, Missouri 65102

MONTANAMontana Department of Health & Human Svcs PHONE #: (406) 444-5580Health Policy and Services Div FAX #: (406) 444-2920Cogswell Building - Room C211 Program Manager: Joyce BurgettP.O. Box 202951 Email: jburgett@state.mt.usHelena, Montana 59620

NEBRASKANebraska Department of Health & Human Services PHONE #: (402) 471-6423Immunization Program FAX #: (402) 471-6426301 Centennial Mall South Program Manager: Barbara LudwigP.O. Box 95044 Email: barbara.ludwig@hhss.ne.govLincoln, Nebraska 68509-5044

NEVADANevada State Health Division PHONE #: (775) 684-5900Immunization Program FAX #: (775) 684-8338505 King Street Program Manager: Bob SalcidoCarson City, Nevada 89710 Email: bsalcido@nvhd.state.nv.us

NEW HAMPSHIRENew Hampshire Department of Health & Human Svcs PHONE #: (603) 271-4482Immunization Program FAX #: (603) 271-3850Six Hazen Drive Program Manager: Michael DumondConcord, New Hampshire 03301 Email: mdumond@dhhs.state.nh.us

NEW JERSEYNew Jersey State Department of Health & Senior Svcs PHONE #: (609) 588-7520Immunization Program FAX #: (609) 588-7431P.O. Box 369 Program Manager: Kate WytovichTrenton, New Jersey 08625-0369 Email: Katherine.Wytovich@doh.state.nj.usFed Ex: 3635 Quaker Bridge RoadMercerville, NJ 08619-9998

NEW MEXICONew Mexico Department of Health PHONE #: (505) 827-2369Immunization Program FAX #: (505) 827-28981190 St. Francis Drive Program Manager: Steve NickellRennels Building - Suite 1261 Email: steveni@doh.state.nm.usSanta Fe, New Mexico 87502

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NEW YORKNew York State Department of Health PHONE #: (518) 473-4437Immunization Program FAX #: (518) 474-7381Corning Tower Building Program Manager: David LynchRoom 649 Email: DRL05@health.state.ny.usAlbany, New York 12237-0627

NEW YORK CITYNew York City Department of Health PHONE #: (212) 676-2259Bureau of Immunization FAX #: (212) 676-22522 Lafayette Street - 19th Floor Program Manager: Jane ZuckerNew York, New York 10007 Email: jzucker@health.nyc.gov

NORTH CAROLINANorth Carolina Division of Public Health PHONE #: (919) 707-5550Immunization Branch FAX #: (919) 870-48241917 Mail Service Center Program Manager: Beth Rowe-WestRaleigh, NC 27699-1917 Email: beth.rowe-west@ncmail.netFed Ex: 5601 Six Forks Road2nd FloorRaleigh, NC 27609-3811

NORTH DAKOTANorth Dakota Department of Health PHONE #: (701) 328-2378Division of Disease Control FAX #: (701) 328-1412State Capitol Program Manager: Heather Weaver600 East Boulevard Email: hweaver@state.nd.usBismarck, North Dakota 58505-0200

OHIOOhio Department of Health PHONE #: (614) 466-4643Immunization Program FAX #: (614) 728-427935 East Chestnut - 7th Floor Program Manager: Tony PaytonColumbus, Ohio 43215 Email: Tpayton@odh.ohio.gov

OKLAHOMAOklahoma State Department of Health PHONE #: (405) 271-4073Immunization Program - 0306 FAX #: (405) 271-61331000 N.E. 10th Street Program Manager: Don BloseOklahoma City, Oklahoma 73117-1299 Email: donb@health.state.ok.us

OREGONOregon Immunization Program PHONE #: (503) 731-4020800 NE Oregon Street FAX #: (503) 731-3095Suite 370 Program Manager: Lorraine DuncanPortland, Oregon 97232 Email: Lorraine.Duncan@state.or.us

PENNSYLVANIAPennsylvania Department of Health PHONE #: (717) 787-5681Division of Immunizations FAX #: (717) 705-5513Rm 1026 Health & Welfare Bldg Program Manager: Alice GrayCommonwealth & Forrester St. Email: agray@state.pa.usHarrisburg, Pennsylvania 17120

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PHILADELPHIAPhiladelphia Department of Health PHONE #: (215) 685-6748Division of Disease Control FAX #: (215) 685-6806500 South Broad Street Program Manager: Andrew ChilkatowskyPhiladelphia, Pennsylvania 19146 Email: andrew.chilkatowsky@phila.gov

RHODE ISLANDRhode Island Department of Health PHONE #: (401) 222-2312mmunization Program FAX #: (401) 222-14423 Capital Hill - Room 302 Program Manager: Becky BessetteProvidence, Rhode Island 02908-5097 Email: BeckyB@doh.state.ri.us

SOUTH CAROLINASouth Carolina Department of Health PHONE #: (803) 898-0460

and Environmental Control FAX #: (803) 898-0318Immunization Division Program Manager: Jesse Greene

1751 Calhoun Street Email: greeneje@dhec.sc.usColumbia, South Carolina 29201

SOUTH DAKOTASouth Dakota Department of Health PHONE #: (605) 773-5323615 East 4th Street FAX #: (605) 773-5509Pierre, South Dakota 57501 Program Manager: Michelle Hudacek

Email: michelle.hudecek@state.sd.usTENNESSEETennessee Department of Health PHONE #: (615) 741-7247Immunization Program FAX #: (615) 741-3857Cordell Hull Building, 4th Floor Program Manager: Pamelia Baggett425 5th Avenue North Email: Pamelia.baggett@state.tn.usNashville, Tennessee 37247-4911

TEXASTexas Department of Health PHONE #: (512) 458-7284Immunization Division FAX #: (512) 458-72881100 West 49th Street Program Manager: Jack SimsAustin, Texas 78756 Email: Jack.sims@dshs.state.tx.us

HOUSTONHouston Health & Human Services Dept PHONE #: (713) 794-9267Immunization Bureau FAX #: (713) 794-99378000 North Stadium Drive Program Manager: Risha JonesHouston, Texas 77054 Email: Risha.Jones@cityofhouston.net

SAN ANTONIOSan Antonio Metro Health District PHONE #: (210) 207-8790Immunization Division FAX #: (210) 207-8882332 West Commerce Street, Suite 202 Program Manager: Brenda LemkeSan Antonio, Texas 78205 Email: BrendaL@sanantonio.gov

UTAHUtah Department of Health PHONE #: (801) 538-9450CFHS/Immunization FAX #: (801) 538-9440P.O. Box 142001 Program Manager: Linda AbelSalt Lake City, Utah 84114-2001 Email: lable@utah.gov

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VERMONTVermont Department of Health PHONE #: (802) 863-7638Immunization Program FAX #: (802) 865-7701P.O. Box 70 Program Manager: Sue Barry108 Cherry Street Email: sbarry@vdh.state.vt.usBurlington, Vermont 05402

VIRGINIAVirginia State Department of Health PHONE #: (804) 864-8055Division of Immunization FAX #: (804) 786-03961500 E. Main Street - Room 120 Program Manager: Jim FarrellRichmond, Virginia 23219 Email: jfarrell@vdh.virginia.gov

WASHINGTONWashington State Department of Health PHONE #: (360) 236-3595Office of Immunization FAX #: (360) 235-3590Newmarket Industrial Campus Program Manager: Janna BardiP.O. Box 47843 Email: jjanna.bardi@doh.wa.govOlympia, Washington 98504-7843Fed Ex: DOH/Immunization ProgramNewmarket Industrial Campus Bldg 17171 Cleanwater LaneOlympia, WA 98501

WASHINGTON, DCDepartment of Public Health PHONE #: (202) 576-7130Preventive Hlth Svcs Administration FAX #: (202) 576-6418Division of Immunization Program Manager: Rosie McLaren1131 Spring Road, N.W. Email: Rmclaren@dc.govWashington, DC 20010

WEST VIRGINIAWest Virginia Department of Health & Human Resources PHONE #: (304) 558-2188Bureau for Public Health FAX #: (304) 558-1941Immunization Program Program Manager: Jeff Neccuzi350 Capitol Street, Rm 125 jeffneccuzi@wvdhhr.orgCharleston, West Virginia 25301-3715

WISCONSINWisconsin Division of Public Health PHONE #: (608) 267-9959Immunization Program FAX #: (608) 267-94931 West Wilson St, Rm 318 Program Manager: Dan HopfenspergerP.O. Box 2659 Email: hopfedj@dhfs.state.wi.usMadison, Wisconsin 53702-2659

WYOMINGWyoming Division of Health PHONE #: (307) 777-7942Community and Family Health Div. FAX #: (307) 777-6001Hathaway Building, Room 424 Program Manager: Katelyn Wells-Fahling2300 Capitol Ave Email: kfahli@state.wy.usCheyenne, Wyoming 82002

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OTHER GRANTEESAMERICAN SAMOADepartment of Health, IM Program PHONE #: 011-684-633-7223Division of Public Health FAX #: 011-684-633-5379Government of American Samoa Program Manager: Joseph TufaLBJ Tropical Medical Center Email: yt_masunu@hotmail.comPago Pago, AS 96799

GUAMDepartment of Public Health and Social Services PHONE #: 011-671-735-7143Immunization Program FAX #: 011-671-734-1475123 Chalan Kareta, Route 10 Program Manager: JosieO’MallanMangilao, Guam 96923 Email: JTOMallan@dphss.govguam.net

INDIAN HEALTH SERVICEIndian Health Services HQ West PHONE #: (505) 248-4226Epidemiology Department - 3rd Floor FAX #: (505) 248-43935300 Homestead Rd., N.E. Program Manager: Amy GroomAlbuquerque, New Mexico 87110 Email: amy.groom@mail.ihs.gov

MARSHALL ISLANDSRepublic of the Marshall Islands PHONE #: 011-692-625-8457Ministry of Health Services FAX #: 011-692-625-3432Immunization Program Program Manager: Mailynn KoneliosP.O. Box 16 Email: phadmin@ntamar.netMajuro, Marshall Island 96960

MICRONESIAFederated States of Micronesia PHONE #: 011-691-320-2619Division of Health Services FAX #: 011-691-320-5263Immunization Program Program Manager: Louisa HelgenbergerP.O. Box PS 70, Palikir Email: lahelgenberger@mail.fmPonape, FM 96941

NORTHERN MARIANA ISLANDSDepartment of Public Health & Environmental Service PHONE #: 011-670-236-8733Commonwealth Health Center FAX #: 011-670-234-8930Lower Navy Hill Program Manager: Mariana SablanP.O. Box 409 Email: mariana@gtepacifica.netSaipan, N. Mariana Is. 96950

PALAUBureau of Health Services PHONE #: 011-680-488-4804Immunization Program FAX #: 011-680-488-3115Republic of Palau Program Manager: Ann KlassBelau National Hosp Building Email: phpal@palaunet.comKoror, RP 96940

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PUERTO RICOPuerto Rico Department of Health PHONE #: (787) 274-5612Immunization Program FAX #: (787) 274-5619Program for Communicable Diseases Program Manager: Angel RiveraP.A.S.E.T., Box 70184 Email: anrivera@salud.gov.prSan Juan, Puerto Rico 00936Fed Ex: Dept. De Salud, Edificio AAntigua Hosp de PsiquiatriaPabellon #1, Primer PisoSeccion de VacunacionRio Piedras, Puerto Rico 00922

VIRGIN ISLANDSVirgin Islands Department of Health PHONE #: (340) 776-8311 ext. 2151Roy L. Schneider Hospital FAX #: (340) 777-8762Immunization Program Program Manager: Joan Montenegro48 Sugar Estate Email: immunize@viaccess.netSt. Thomas, Virgin Islands 00802