Immunization Medical Exemption and Surveillance Specialist, Bureau of Immunization

The mission of the Bureau of Immunization (BOI) is to prevent the occurrence and transmission of vaccine-preventable diseases (VPDs) through comprehensive immunization programs. BOI promotes immunization across the lifespan from infancy through adulthood, works to eliminate disparities in vaccination coverage through data evaluation and support of equitable vaccination services, and actively responds to VPD outbreaks to mitigate their spread and impact on communities.

The BOI School Compliance Unit (SCU) is responsible for ensuring that children attending childcare programs and schools are vaccinated in accordance with New York State immunization requirements. The BOI Surveillance Unit is responsible for conducting surveillance of measles, mumps, rubella, diphtheria, tetanus, pertussis, polio, varicella, and invasive pneumococcal disease in children aged less than 5 years and assuring the institution of control measures and outbreak response.

The Surveillance Unit is also responsible for the management and analysis of surveillance data and monitoring the impact of new vaccines.

The Immunization Medical Exemption and Surveillance Specialist will report to the Director of Epidemiology and Surveillance and will work with both SCU and the Surveillance Unit. With the SCU, the Medical Specialist will be a primary physician responsible for reviewing requests for medical exemptions to immunizations submitted by medical providers for children attending childcare and school. The Medical Specialist will determine if the exemption request is valid based on national guidance and recommendations.

The Medical Specialist would also work on various aspects of emergency and outbreak responses for vaccine preventable diseases, as needed. This includes serving as a medical liaison to exposure sites to provide guidance on contact identification and notification, immunity assessments, and post-exposure prophylaxis for measles. They would coordinate referrals to healthcare facilities for prophylaxis and titers for community contacts and would provide guidance to specialists for high-risk contacts, including pregnant and immunocompromised individuals.

They would also be the point of contact for receiving clinical updates from infection control and providers for hospitalized cases and contacts and for relaying test results in these settings. They would assist in other aspects of outbreak responses, as needed.

• Receive and review medical exemption requests to immunizations including any accompanying medical documentation.
• Determine the validity of the medical exemption requests through discussion with the submitting physician, BOI physicians and external consultants as needed.
• Enter exemption request data and use the data entry system to describe trends in medical exemption requests and the submitting physicians.
• Draft written guidance to medical providers and schools regarding immunization exemptions.
• Serve as a medical liaison to sites of exposures for vaccine preventable diseases to provide guidance on contact identification and notification immunity assessments, and control measures.
• Collaborate with medical providers for high-risk contacts to determine need for PEP based on the contacts’ medical conditions.
• Coordinate referrals for titers for assessment of serologic immunity for vaccine preventable diseases and referrals to healthcare facilities for PEP for people exposed in community settings.
• Document updates in the surveillance database, Maven.
• Assist in other aspects of outbreak responses, as needed.
• Participate in BOI activities, such as the Doctor-of-the-Week rotation.
• Participate in additional DOHMH activities, such as the Doctor-on-Call program and emergency…