Learning Objectives for this Presentation:
By the end of this presentation participants will be able to identify the consequences of a mandated removal of thimerosal from childhood vaccines for children 3 years of age and younger. Participants will be able to contrast vaccination rates for pregnant women pre and post implementation of thimerosal free vaccination.

Background:
As of Dec. 31, 2006, no thimerosal-containing vaccines were permitted in Suffolk County Department of Health Services (SCDHS) facilities and programs for all children 3 years of age and younger and pregnant women. Any vaccine containing even a trace amount of thimerosal was no longer acceptable under these regulations. AFIX assessments reached 91% in 2006. Serious concerns were raised on future immunization rates for both children and pregnant women.

Setting:
SCDHS runs eight primary care health centers, three satellites, and children's immunization clinics at various locations throughout Suffolk County New York.

Population:
Suffolk County is a suburban county with a population of 1.4 million people. There were 3,013 births in 2006. Children and women make up the largest segments of the populations in the health centers.

Project Description:
AFIX assessments were used to determine immunization rates for the same time periods in 2006 and 2007. The nurses' immunization log books were used to measure immunization levels for pregnant women. The nurses were also asked to monitor the time it took to prepare, administer, and monitor more immunizations per visit since several of the combination vaccines used previously were no longer permitted.

Results/Lessons Learned:
Localities adopting such restrictions should be prepared for drops in immunization rates and for increased work effort to sustain vaccination rates.