“We were also able to look at some of the intermediate-acuity patients—fairly complicated but not requiring ventilators,” she explains. “Our study wasn’t sufficiently powered for this subgroup, but it was an interesting piece of data to raise the question: Where should we deploy this scarce resource of intensivists? Which pockets of patients?”
Presenting her abstract at SHM’s annual meeting was a “good experience.”
“I’d done public speaking before, but never with an audience of about 500 people,” she says. “To go out there and field their questions was a real professional growing experience. Several people interested in the topic sought me out at the conference, introduced themselves, and we have subsequently stayed in touch.”
The manuscript published in JHM has been cited four times, including in a position paper from SHM and the Society of Critical Care Medicine.3 Another outgrowth of the research was being asked to contribute a chapter on hospitalists’ role in the ICU to a textbook on hospital medicine. Based on her still-fresh HM presentation, Dr. Wise was one of the few publicly identified experts on the subject. The chapter, co-authored by fellow Emory hospitalist Michael Heisler, MD, MPH, “The Role of the Hospitalist in Critical Care” was included in Principles and Practices of Hospital Medicine.4
Title: Neonatal intensivist
Institution: Stony Brook University Hospital, Great Neck, N.Y.
RIV: “Administration of Inactivated Trivalent Influenza Vaccine (TIV) to Parents of Infants in the Neonatal Intensive Care Unit (NICU): A Novel Strategy to Increase Vaccination Rates” (innovations)
Citation: Shah SI, Caprio M, Hendricks-Munoz K. Administration of inactivated trivalent influenza vaccine to parents of high-risk infants in the neonatal intensive care unit. Pediatrics. 2007;120;e617-e621.
Dr. Shah was in his final year of a fellowship in neonatology at New York University when he took on the challenge of improving immunization access to protect premature, highly vulnerable patients in the NICU from influenza infections. Because these children are too young to be vaccinated directly, the concept of cocooning them from infection involves extending protection to everyone around them.
“We came up with the idea of offering flu vaccinations 24/7 in the NICU to the children’s parents,” he says. “It worked well for us as a way to define an indicated therapy for a defined population, even if it was a little outside the box. By the end of the flu season, 95% of the parents were vaccinated.”
SHM recognized the project as the top RIV innovations poster at HM06, but that was just the beginning.
“When I moved to SUNY Stony Brook, I continued to study and advocate for these vaccinations,” Dr. Shah says. “We were giving 500 to 700 vaccinations a year. Then I wrote a national resolution for the American Academy of Pediatrics, which was significant because it meant AAP was behind the project.”
Dr. Shah later became chair of AAP’s Long Island Chapter Legislative Committee and joined a statewide pediatric advocacy group. In 2009, the New York legislature enacted the Neonatal Influenza Protection Act, which required hospitals in the state to offer parents the vaccine, with Dr. Shah’s research and advocacy providing an essential basis for its passage. He’s even been recognized for his research in congressional citations.
Based on that success with influenza vaccinations, Dr. Shah and his colleagues looked at other diseases, starting with pertussis, and then tetanus, diphtheria, and whooping cough.5 All the while, they continued tracking immunization rates. A second state law, passed in 2011, added pertussis to the vaccinations. Next on his advocacy agenda is a project to promote smoking-cessation interventions in the NICU.6