Raise Your Voice for Meningococcal Disease Vaccination

2. Slide 2 Welcome [NAME] [TITLE] [National Association of School Nurses Affiliate]

3. Slide 3 Clinical Overview: Meningococcal Disease Infection caused by the bacterium Neisseria meningitidis1 Serotypes A, B, C, Y, and W-135 cause majority of meningococcal disease cases worldwide2 Leading cause of bacterial meningitis among US toddlers, children and adolescents Serotypes B, C, and Y most common in US2 Meningococcal disease can cause meningitis (swelling of the brain or spinal cord) or meningococcemia (blood infection)3 Vaccination is safe and effective and the best way to help prevent the disease among adolescents3 Meningococcal disease, which includes meningitis, is a serious bacterial infection caused by bacterium called Neisseria meningitidis.1-2 There are 5 serotypes or strains of meningococcal disease � A, B, C, Y, and W-135 � that cause the majority of infection worldwide.3 Meningococcal disease is a leading cause of bacterial meningitis among toddlers, children, and adolescents in the US, and serotypes B, C, and Y are the most common here.3 Meningococcal disease can result in meningitis, a swelling of the brain or spinal cord, or meningococcemia, which is a blood infection.2 Meningococcal vaccination continues to be safe and effective, and is the best way to help protect preteens and teens from getting the disease.2 Meningococcal disease, which includes meningitis, is a serious bacterial infection caused by bacterium called Neisseria meningitidis.1-2 There are 5 serotypes or strains of meningococcal disease � A, B, C, Y, and W-135 � that cause the majority of infection worldwide.3 Meningococcal disease is a leading cause of bacterial meningitis among toddlers, children, and adolescents in the US, and serotypes B, C, and Y are the most common here.3 Meningococcal disease can result in meningitis, a swelling of the brain or spinal cord, or meningococcemia, which is a blood infection.2 Meningococcal vaccination continues to be safe and effective, and is the best way to help protect preteens and teens from getting the disease.2

4. Slide 4 Approximately 1000 to 2600 Americans get meningococcal disease annually1 The disease rates peak at 15-19 years of age2 When meningococcal disease occurs the consequences can be devastating1 Fast progressing�can take a life in just a single day3 Teens are up to 5 times more likely to die than other age groups2 Among survivors, 1 in 5 will suffer permanent complications Amputation, hearing loss, neurological damage, and organ failure1,4 Early symptoms can resemble the flu, making diagnosis difficult Symptoms include fever, headache, stiff neck, nausea and vomiting, and rash5-6 Clinical Overview: Meningococcal Disease Though meningococcal disease is rare � about 1000 to 2600 cases occur each year � it�s often devastating.1 The disease moves quickly in the body and can take a child�s life in just a single day.2 Preteens and teens are at greater risk for getting meningococcal disease; the disease peaks at 15 through 19 years of age.3 Death rates are up to 5 times higher among teenagers and young adults compared with other age groups, and up to 1 in 5 survivors are left with serious medical problems including, amputation of arms, legs, fingers, and toes; brain damage; deafness; and kidney damage.1,3,4 Preventing meningococcal disease is particularly important because early symptoms can be similar to flu-like symptoms, making the disease hard to recognize by parents and difficult to diagnose by health-care providers.5 Early symptoms of meningococcal disease include high fever, severe headache, stiff neck, and nausea and vomiting.5-6 A purplish rash may also appear. 5-6 Though meningococcal disease is rare � about 1000 to 2600 cases occur each year � it�s often devastating.1 The disease moves quickly in the body and can take a child�s life in just a single day.2 Preteens and teens are at greater risk for getting meningococcal disease; the disease peaks at 15 through 19 years of age.3 Death rates are up to 5 times higher among teenagers and young adults compared with other age groups, and up to 1 in 5 survivors are left with serious medical problems including, amputation of arms, legs, fingers, and toes; brain damage; deafness; and kidney damage.1,3,4 Preventing meningococcal disease is particularly important because early symptoms can be similar to flu-like symptoms, making the disease hard to recognize by parents and difficult to diagnose by health-care providers.5 Early symptoms of meningococcal disease include high fever, severe headache, stiff neck, and nausea and vomiting.5-6 A purplish rash may also appear. 5-6

5. Slide 5 Clinical Overview: Meningococcal Disease Spread from person to person through close, personal contact and exchange of respiratory secretions1 Common everyday activities can put adolescents at increased risk for infection; these activities or risks include:1-2 Sharing drinking glasses and eating utensils Kissing Living in close quarters Smoking (or being exposed to smoke) Meningococcal disease can occur at any point during the year Late-winter and early-spring are when most cases occur3 Meningococcal disease can be spread from one person to another through close, personal contact with someone sick with the disease or a carrier of the bacteria.1 Activities common among preteens and teens are thought to put them at greater risk for infection. These activities include kissing, and sharing eating utensils or drinking glasses. Living in close quarters � like at overnight camps and dormitories � also can put preteens and teens at increased risk. Studies show smoking or being exposed to smoke can diminish the functionality of the mucus membranes that help to act as a barrier against the disease, and may contribute to this increased risk.1-2 Meningococcal disease can occur during any point in the year, but late-winter and early-spring are when most cases occur.3 Meningococcal disease can be spread from one person to another through close, personal contact with someone sick with the disease or a carrier of the bacteria.1 Activities common among preteens and teens are thought to put them at greater risk for infection. These activities include kissing, and sharing eating utensils or drinking glasses. Living in close quarters � like at overnight camps and dormitories � also can put preteens and teens at increased risk. Studies show smoking or being exposed to smoke can diminish the functionality of the mucus membranes that help to act as a barrier against the disease, and may contribute to this increased risk.1-2 Meningococcal disease can occur during any point in the year, but late-winter and early-spring are when most cases occur.3

6. Slide 6 Clinical Overview: Meningococcal Disease Once diagnosed with meningococcal disease, early antibiotic treatment is critical1 Even with treatment, meningococcal disease can kill an otherwise healthy young person1-2 Close contacts should also receive preventive antibiotics1 Family members, close friends Once meningococcal disease has been diagnosed through spinal or blood testing, prompt treatment is critical.1 But even with prompt medical treatment, meningitis can kill an otherwise healthy young person in just a single day, underscoring the importance of prevention.1-2 People who may have had close contact with an individual diagnosed with meningococcal disease should also receive preventive antibiotics.1 It�s important to know that most cases of meningococcal disease are sporadic; outbreaks of the disease are rare.3 Once meningococcal disease has been diagnosed through spinal or blood testing, prompt treatment is critical.1 But even with prompt medical treatment, meningitis can kill an otherwise healthy young person in just a single day, underscoring the importance of prevention.1-2 People who may have had close contact with an individual diagnosed with meningococcal disease should also receive preventive antibiotics.1 It�s important to know that most cases of meningococcal disease are sporadic; outbreaks of the disease are rare.3

7. Slide 7 Vaccination � The Best Protection Vaccination continues to be the best way to prevent meningococcal disease Helps protect against 4 of the 5 primary serotypes (A, C, Y, and W-135)1 Centers for Disease Control and Prevention (CDC) recommends routine vaccination for:2-3 Adolescents 11-18 years of age College freshmen living in dormitories Children 2 through 10 years of age at increased risk Anyone 2 through 10 years of age if elected by parent or health-care provider Given the quick and often devastating nature of meningococcal disease, vaccination remains the best way to prevent the disease.1 Meningococcal vaccination has been available for decades as a safe and effective way to help protect against meningitis.2 Vaccines are available to help protect against serotypes A, C, Y, and W-135, which are 4 out of the 5 primary serotypes that account for the majority of meningococcal cases worldwide.1 The CDC and other leading medical groups recommend vaccination for:3-4 Preteens and teens 11 through 18 years of age; � College freshmen living in dormitories; � Children 2 through 10 years of age who are at increased risk, such as children who have a poorly functioning spleen or have had their spleen removed, or children with an immune system disorder; Or anyone 2 through 10 if elected by their health-care provider or parent. The CDC recommends adolescents receive the meningococcal vaccine during the pre-adolescent health-care visit, which is also supported by key medical groups, including the National Association of School Nurses, American Academy of Pediatrics, American Academy of Family Physicians, and American Medical Association. Unvaccinated adolescents should receive the meningococcal vaccine at the earliest possible health-care visit.3 As school nurses we should encourage vaccination and urge students to avoid behaviors that may contribute to the spread of meningococcal disease and other infectious disease, such as sharing of personal items.5Given the quick and often devastating nature of meningococcal disease, vaccination remains the best way to prevent the disease.1 Meningococcal vaccination has been available for decades as a safe and effective way to help protect against meningitis.2 Vaccines are available to help protect against serotypes A, C, Y, and W-135, which are 4 out of the 5 primary serotypes that account for the majority of meningococcal cases worldwide.1 The CDC and other leading medical groups recommend vaccination for:3-4 Preteens and teens 11 through 18 years of age; � College freshmen living in dormitories; � Children 2 through 10 years of age who are at increased risk, such as children who have a poorly functioning spleen or have had their spleen removed, or children with an immune system disorder; Or anyone 2 through 10 if elected by their health-care provider or parent. The CDC recommends adolescents receive the meningococcal vaccine during the pre-adolescent health-care visit, which is also supported by key medical groups, including the National Association of School Nurses, American Academy of Pediatrics, American Academy of Family Physicians, and American Medical Association. Unvaccinated adolescents should receive the meningococcal vaccine at the earliest possible health-care visit.3 As school nurses we should encourage vaccination and urge students to avoid behaviors that may contribute to the spread of meningococcal disease and other infectious disease, such as sharing of personal items.5

8. Slide 8 Vaccination Rates Alarmingly Low In 2008, only 41.8% of teens 13-17 years of age received the recommended meningococcal vaccine1 Far from the CDC�s goal of a 90% immunization rate2 Florida has a 33.6% rate of meningococcal vaccination among adolescents 13-17 years of age Even with public health recommendations, meningococcal vaccination rates remain alarming low.1 The recent National Immunization Survey found that only 41.8 percent of adolescents 13 through 17 years of age have received the recommended meningococcal vaccine, which is far below the CDC�s goal of a 90 percent immunization rate among this age group.1-2 Our state has a meningococcal vaccination rate of [Insert NIS Data*], leaving too many of our students unprotected. As school nurses, we can help support the CDC�s recommendations by educating parents and students about meningococcal disease and importance of vaccination. *Please use the below link to find statistical data for meningococcal vaccination rates in your state: http://www.cdc.gov/vaccines/stats-surv/nisteen/tables/08/tab01_iap.xls Even with public health recommendations, meningococcal vaccination rates remain alarming low.1 The recent National Immunization Survey found that only 41.8 percent of adolescents 13 through 17 years of age have received the recommended meningococcal vaccine, which is far below the CDC�s goal of a 90 percent immunization rate among this age group.1-2 Our state has a meningococcal vaccination rate of [Insert NIS Data*], leaving too many of our students unprotected. As school nurses, we can help support the CDC�s recommendations by educating parents and students about meningococcal disease and importance of vaccination. *Please use the below link to find statistical data for meningococcal vaccination rates in your state: http://www.cdc.gov/vaccines/stats-surv/nisteen/tables/08/tab01_iap.xls

9. Slide 9 Why Aren�t More Teens Getting Vaccinated?1-3 Many parents and students still unaware of disease, vaccine Fewer health maintenance visits Missed immunization opportunities Lack of population-based immunization registries that include adolescents Low public awareness about adolescent immunization coverage, recommendations, and available vaccinations Misperceptions about vaccine safety There are many factors that contribute to low vaccination rates among adolescents. Many parents and students may still be unaware of the dangers of meningococcal disease and the importance of vaccination.1 We also know that health visits tend to decrease among the adolescent age group, which can lead to fewer opportunities for vaccination.2 But, every health-care visit is an opportunity to discuss meningococcal vaccination.3 Additionally, there continues to be a misperception among some parents about the safety of vaccines, especially surrounding newer vaccines like the meningococcal vaccine. A survey from the journal Pediatrics found that nearly 32 percent of parents actually declined the meningococcal vaccine.4 As school nurses, we can help to address these issues by helping to educate our communities.There are many factors that contribute to low vaccination rates among adolescents. Many parents and students may still be unaware of the dangers of meningococcal disease and the importance of vaccination.1 We also know that health visits tend to decrease among the adolescent age group, which can lead to fewer opportunities for vaccination.2 But, every health-care visit is an opportunity to discuss meningococcal vaccination.3 Additionally, there continues to be a misperception among some parents about the safety of vaccines, especially surrounding newer vaccines like the meningococcal vaccine. A survey from the journal Pediatrics found that nearly 32 percent of parents actually declined the meningococcal vaccine.4 As school nurses, we can help to address these issues by helping to educate our communities.

10. Slide 10 Vaccination Requirements in Elementary and Secondary Schools1-4 This map illustrates states that require meningococcal disease education among adolescents, such as Washington, Georgia, and Tennessee, and those states which require the meningococcal vaccine for adolescents, such as Texas, New Jersey, and Arizona.1 If your state has a meningococcal disease mandate: In [Insert State] meningococcal disease [education and/or vaccination] [is/are] required for adolescents. [Insert state] requires adolescents receive [education and/or vaccination] prior to [Insert specific age requirements for state]. Even with this mandate, it�s important that we educate parents about why meningococcal disease is important, to ensure they understand and choose to vaccinate their child. If your state does not have a meningococcal disease mandate: Currently, [Insert state] has no [education and/or vaccination] requirements for meningococcal disease among adolescents. This makes our job of disease education all the more important among this age group.This map illustrates states that require meningococcal disease education among adolescents, such as Washington, Georgia, and Tennessee, and those states which require the meningococcal vaccine for adolescents, such as Texas, New Jersey, and Arizona.1 If your state has a meningococcal disease mandate: In [Insert State] meningococcal disease [education and/or vaccination] [is/are] required for adolescents. [Insert state] requires adolescents receive [education and/or vaccination] prior to [Insert specific age requirements for state]. Even with this mandate, it�s important that we educate parents about why meningococcal disease is important, to ensure they understand and choose to vaccinate their child. If your state does not have a meningococcal disease mandate: Currently, [Insert state] has no [education and/or vaccination] requirements for meningococcal disease among adolescents. This makes our job of disease education all the more important among this age group.

11. Slide 11 School Nurses: Helping to Prevent Meningococcal Disease School nurses play an instrumental role in raising awareness about meningococcal disease and vaccination Leading advocate in adolescent health Direct reach to adolescents, parents, and families Trusted source of health information Parents rely on school nurses for information surrounding the health and well-being of their children School nurses are on the front line with students every day and we can play an instrumental role in educating about meningococcal disease. For some students, school nurses are the only health-care professionals they ever see in non-emergency situations, and parents rely on school nurses to provide them with information about the health and well-being of their kids. This is why it is critical we help to raise awareness about meningococcal disease and vaccination. School nurses are on the front line with students every day and we can play an instrumental role in educating about meningococcal disease. For some students, school nurses are the only health-care professionals they ever see in non-emergency situations, and parents rely on school nurses to provide them with information about the health and well-being of their kids. This is why it is critical we help to raise awareness about meningococcal disease and vaccination.

12. Slide 12 Become a �Voice� of Meningitis A public awareness campaign by the National Association of School Nurses (NASN) in collaboration with sanofi pasteur Gives �voice� to meningitis through sharing stories of those personally affected by the disease Parents Disease survivors School nurses How You Can Help Support Educational Efforts in Florida We can make a difference by raising our voice and joining the Voices of Meningitis educational efforts. Voices of Meningitis is an educational campaign of the NASN, in collaboration with sanofi pasteur, a vaccine industry leader and pioneer in meningococcal vaccine development. The campaign brings together school nurses from across the country, along with families personally affected by meningococcal meningitis, to share their personal experiences and give �voice� to this rare, but serious disease. We can make a difference by raising our voice and joining the Voices of Meningitis educational efforts. Voices of Meningitis is an educational campaign of the NASN, in collaboration with sanofi pasteur, a vaccine industry leader and pioneer in meningococcal vaccine development. The campaign brings together school nurses from across the country, along with families personally affected by meningococcal meningitis, to share their personal experiences and give �voice� to this rare, but serious disease.

13. Slide 13 Voices of Meningitis Objectives Empower school nurses to further educate parents, teens Parents rely on school nurses for health information Educate parents and teens about dangers of meningococcal disease, encourage them to seek vaccination Encourage dialog between parents, school nurses, and other health-care providers about meningococcal vaccination The objectives of Voices of Meningitis are to: Further empower school nurses and provide them with tools and resources to further educate parents to seek vaccination for their preteen and teenage children. And to encourage a dialog between parents, school nurses, and other health- care providers about disease prevention. The objectives of Voices of Meningitis are to: Further empower school nurses and provide them with tools and resources to further educate parents to seek vaccination for their preteen and teenage children. And to encourage a dialog between parents, school nurses, and other health- care providers about disease prevention.

14. Slide 14 Voices of Meningitis Challenge �Challenges� school nurses to implement meningococcal educational efforts Provides school nurses with resources and strategies Recognizes school nurses for their educational efforts Highlights successes in raising awareness of meningococcal disease and prevention Fosters sharing of ideas and strategies nationwide As part of the Voices of Meningitis campaign, the National Association of School Nurses (NASN) and sanofi pasteur have initiated a Voices of Meningitis Challenge. The purpose of the Challenge is to encourage school nurses to implement meningococcal educational efforts. The program provides school nurses with resources to assist in implementing activities and recognizes school nurses for their efforts. Another goal of the Challenge is to help foster the sharing of ideas and strategies to educate about meningitis among NASN members across the country. As part of the Voices of Meningitis campaign, the National Association of School Nurses (NASN) and sanofi pasteur have initiated a Voices of Meningitis Challenge. The purpose of the Challenge is to encourage school nurses to implement meningococcal educational efforts. The program provides school nurses with resources to assist in implementing activities and recognizes school nurses for their efforts. Another goal of the Challenge is to help foster the sharing of ideas and strategies to educate about meningitis among NASN members across the country.

15. Slide 15 Voices of Meningitis Challenge Challenge �Champions� to offer guidance and support To that end, the National Association of School Nurses (NASN) has identified Challenge �Champions� for each region. These �Champions� are NASN members who can offer guidance as you embark on this Challenge. Following is a map of the US, showing a breakdown of the regions and respective �Champions.� Feel free to contact your region�s �Champion� if you have any questions or need any advice or support. To that end, the National Association of School Nurses (NASN) has identified Challenge �Champions� for each region. These �Champions� are NASN members who can offer guidance as you embark on this Challenge. Following is a map of the US, showing a breakdown of the regions and respective �Champions.� Feel free to contact your region�s �Champion� if you have any questions or need any advice or support.

16. Slide 16 Voices of Meningitis Challenge Implementation Guide Provides ideas to initiate meningococcal disease awareness programming within communities Educational materials Posters Brochure Fact sheet Report card sticker Parent letters Media materials Educational videos Complimentary materials available on VoicesOfMeningitis.org In addition to your Regional �Champion�s� support, the National Association of School Nurses (NASN) and sanofi pasteur have provided a comprehensive �how-to guide� including ideas and strategies to help kick-start Challenge efforts. I�ll discuss some of these ideas with you in a few moments. Additionally, you also will have a plethora of complimentary Voices of Meningitis materials to use in your educational efforts. We have ready-to-use print materials, including brochures, posters, fact sheets, and report card stickers. Template materials, such as various parent letters, a letter for local partners, and a letter for other public health professionals, are also available. These materials can be customized with your name and school�s information for easy use. You also will have access to media materials, including sample media alerts, newspaper articles, and letters to the editor, to help publicize your efforts and reach even more parents within your community. Families involved with the campaign also have created compelling videos sharing their stories to underscore the importance of disease prevention. All materials are available online with select pieces available for complimentary hard copy orders through Voices of Meningitis dot org. Materials are available in both English and Spanish. We will be adding more materials throughout the year, so please check the Web site often. In addition to your Regional �Champion�s� support, the National Association of School Nurses (NASN) and sanofi pasteur have provided a comprehensive �how-to guide� including ideas and strategies to help kick-start Challenge efforts. I�ll discuss some of these ideas with you in a few moments. Additionally, you also will have a plethora of complimentary Voices of Meningitis materials to use in your educational efforts. We have ready-to-use print materials, including brochures, posters, fact sheets, and report card stickers. Template materials, such as various parent letters, a letter for local partners, and a letter for other public health professionals, are also available. These materials can be customized with your name and school�s information for easy use. You also will have access to media materials, including sample media alerts, newspaper articles, and letters to the editor, to help publicize your efforts and reach even more parents within your community. Families involved with the campaign also have created compelling videos sharing their stories to underscore the importance of disease prevention. All materials are available online with select pieces available for complimentary hard copy orders through Voices of Meningitis dot org. Materials are available in both English and Spanish. We will be adding more materials throughout the year, so please check the Web site often.

17. Slide 17 Voices of Meningitis Challenge Submit case studies of all awareness activities conducted Case studies featured on the National Association of School Nurses (NASN) Web site Serves as repository of ideas and strategies for school nurses nationwide Five case studies selected to be presented during the 2011 NASN Annual Conference Online submission form on NASN Web site As you conduct activities in your schools, we urge you to submit case studies detailing your successes. No educational effort is too small, so please share your efforts. These case studies will be available for viewing on the NASN Web site, giving nurses nationwide the opportunity to learn from your efforts and share ideas. In December 2010, 5 case studies will be selected by NASN to be presented during the 2011 NASN Annual Conference in Washington, DC. An online case study submission form and sample case study are available on the NASN Web site. I encourage you to submit all activities you conduct as a case study to NASN.As you conduct activities in your schools, we urge you to submit case studies detailing your successes. No educational effort is too small, so please share your efforts. These case studies will be available for viewing on the NASN Web site, giving nurses nationwide the opportunity to learn from your efforts and share ideas. In December 2010, 5 case studies will be selected by NASN to be presented during the 2011 NASN Annual Conference in Washington, DC. An online case study submission form and sample case study are available on the NASN Web site. I encourage you to submit all activities you conduct as a case study to NASN.

18. Slide 18 Tips to Use Online Resources Parent Mailings and Report Cards Send a Voices of Meningitis brochure or letter home to your students� parents School Assembly Discuss meningitis during a school assembly or pep rally Show a Voices of Meningitis educational video Local Parent Teacher Association or Organization Partnership Host a presentation during a regular scheduled meeting; distribute materials Athletic Department Partnership Involve athletic directors to distribute Voices of Meningitis fact sheets with sports physical forms As I mentioned earlier, the Voices of Meningitis implementation guide is a great resource to help brainstorm activities you can implement in your community to help raise awareness about meningococcal disease. As school nurses, we have opportunities to reach parents in ways others may not. Think about sending educational mailings home to your students� parents, or speak during a school assembly or PTA or PTO meeting about the importance of vaccination. Involve other school faculty members to become involved in your efforts. One idea is to engage your school�s athletic department to distribute educational materials with sports physical forms and encourage athletes to not share water bottles. Think outside the box, reach out to your local public health department or local immunization coalition about partnering on different activities, too. As I mentioned earlier, the Voices of Meningitis implementation guide is a great resource to help brainstorm activities you can implement in your community to help raise awareness about meningococcal disease. As school nurses, we have opportunities to reach parents in ways others may not. Think about sending educational mailings home to your students� parents, or speak during a school assembly or PTA or PTO meeting about the importance of vaccination. Involve other school faculty members to become involved in your efforts. One idea is to engage your school�s athletic department to distribute educational materials with sports physical forms and encourage athletes to not share water bottles. Think outside the box, reach out to your local public health department or local immunization coalition about partnering on different activities, too.

19. Slide 19 Happy (and Healthy) Graduation Send information home with order forms for yearbooks, class rings, cap and gown, etc. Set up a table at college fairs Online vehicles Distribute a note about meningitis vaccination via your school�s parent listserv Use the Voices of Meningitis widget to link your school�s Web site with the campaign site Visit VoicesOfMeningitis.org Includes more information and ideas Tips to Use Online Resources (con�t) Also, think about what you can do during key times of the school year, such as graduation. Students often bring home forms to order yearbooks, class rings, and cap and gowns. Why not include information about vaccination prior to college? Or host a table at the school or district college fair where you can distribute information to prospective students and their parents. Since so many parents and students get their information online, you also can post an alert on the school�s parent listserv about the importance of meningitis vaccination, or link your school�s Web site to the campaign Web site where they can obtain additional information. For additional ideas on what types of awareness activities you can do through the Voices of Meningitis Challenge, visit Voices of Meningitis dot org. Also, think about what you can do during key times of the school year, such as graduation. Students often bring home forms to order yearbooks, class rings, and cap and gowns. Why not include information about vaccination prior to college? Or host a table at the school or district college fair where you can distribute information to prospective students and their parents. Since so many parents and students get their information online, you also can post an alert on the school�s parent listserv about the importance of meningitis vaccination, or link your school�s Web site to the campaign Web site where they can obtain additional information. For additional ideas on what types of awareness activities you can do through the Voices of Meningitis Challenge, visit Voices of Meningitis dot org.

20. Slide 20 Questions? Thank you for participating in today�s session. By working together, school nurses in [Insert State] can have a major impact and win this Challenge! I�d now like to open the floor to questions. Thank you for participating in today�s session. By working together, school nurses in [Insert State] can have a major impact and win this Challenge! I�d now like to open the floor to questions.