* 1. Does your program currently have an immunization advocacy project?

* 2. Has your program ever had an immunization advocacy project?

* 3. If yes to the above select which best applies:

* 4. Does your program have an immunization education curriculum in place?

* 5. Has your program had a presentation with the subject of vaccines or vaccine preventable illness during a Grand Rounds or other setting?

* 6. Does your clinic have large numbers of parents refusing vaccines?

* 7. If so, what reasons do they give, select the best answer:

* 8. Does your program require residents to develop and maintain Quality Improvement projects?

* 9. If so, are any of these projects currently focused on improving vaccine rates in your clinic?

* 10. If so, are any of these projects focused on educating your community on vaccine safety or vaccine education?

* 11. Does your clinic use the Vaccine Adverse Effects Reporting System (VAERS)?

* 12. If no, is there a system in place so that all vaccine adverse events are reported?

* 13. Are you aware that the AAP program delegate to the NCE is responsible for presenting the “ImmuneWise Noon Conference” presentation to your program (this presentation is located on the CDRom that was distributed at the NCE and available on line at www.aap.org/ypn/r/advocacy

* 14. Prior to taking this questionnaire were you aware of the Advocacy Modules on the AAP Web site?