KEYWORDS:
Requirements, Regulations, Legislation, Partnerships, Media Campaigns

BACKGROUND:
In 1977 Alaska was the first state to successfully enforce immunization requirements for students in schools and childcare facilities. By the mid-1990s, conventional wisdom prevalent in the U.S. indicated states would encounter insurmountable barriers if they attempted to expand immunization requirements. Nevertheless, in the fall of 2001 Alaska successfully implemented new requirements for all children in schools and licensed childcare facilities to be immunized against hepatitis A and hepatitis B. In addition, immunization against Haemophilus influenzae type b and varicella was required for children in childcare facilities.

OBJECTIVE(S):
Implement new immunization requirements for hepatitis A, hepatitis B, Hib, and varicella for childcare facility attendees, as well as hepatitis A and hepatitis B for all students in grades K-12.

METHOD(S):
During 1999-2000, revise Alaska regulations. In addition, secure partnerships with key persons/groups to support new immunization requirements. Conduct major media outreach for parents, schools, childcare facilities, and providers. Enforce new requirements in fall of 2001.

RESULT(S):
In less than two years, Alaska successfully implemented new immunization requirements for over 150,000 children in all Alaska schools and childcare facilities.

CONCLUSIONS(S):
Alaska's experience indicates effective partnerships and major outreach efforts can overcome potential obstacles to the implementation of new immunization requirements. Overwhelming support exists for childhood immunization requirements.

LEARNING OBJECTIVES:
Describe the numerous steps and activities involved in the successful implementation of a major expansion to statewide immunization requirements.