Context: Despite the increased recognition of the importance of having informatics-competent public health professionals, the competency level of the public health workforce in public health informatics (PHI) has not been examined extensively in the literature. Objective: The purpose of this study was to assess public health workforce informatics competencies in select Georgia health districts and determine the correlates of PHI proficiency. Methods: This study is based on a cross-sectional quantitative study design. We conducted an online self-administered survey of employees from 3 selected district health departments to assess proficiency in foundational PHI competency domains. Three hundred thirty-three respondents completed the survey, with a response rate of 32.5%. A gap score was calculated as a proxy to identify informatics training needs. A path analysis was conducted to assess the relationships among contextual factors and foundational PHI competency domains. Results: The public health employees participating in this study reported relatively high proficiency in foundational PHI competency. Psychometric testing of the competency assessment instrument revealed 2 foundational informatics competency domains-effective information technology (IT) use and effective use of information. The effective use of IT mediated the relationship between employee-level factors of age and past informatics training and the effective use of information. Conclusion:The study highlights the importance of improving the ability of public health professionals to leverage IT and information to advance population health. Periodic assessment of staff PHI competencies can help proactively identify competency gaps and address needs for additional training. Short assessment tools, such as presented in this study, can be validated and used for such assessments.

Background: According to the World Health Organization (WHO), vaccination has reduced the burden of infectious diseases to a significant extent. In recent times, however, the focus has been more on vaccine safety rather than effectiveness. As with any other public health program, immunizations and associated policies are designed to protect the health of the public. Compared to minor risks of side effects of vaccination, the risk of infection often rationalizes the use of vaccination. In states like Georgia, with fewer outbreaks associated with non-vaccination, the need to access community immunity remains constant. Though some articles have assessed parental refusal of childhood vaccination as an ethical concern, few have addressed the economic burden to society as a result of parental rights to refuse vaccination in the ethical contexts of rights, outbreak costs, and community safety. Methods:A literature review was conducted on both qualitative and quantitative studies that described the ethical issues associated with parental refusal of child vaccinations. Electronic databases through PubMed and EBSCO search engines were examined for studies conducted between 2012-2018. Five reviewers independently assessed those articles for content and relevance.Results: Forty-seven articles were identified by a subject matter expert and assessed by the five reviewers. Nineteen articles, based on relevance and theme were selected by consensus to include in this review. Article themes of "rights of parents," "community rights," and "costs associated with outbreak or mitigation of outbreak" were examined. Conclusions:Ethical issues of community safety and costs of the outbreak, as well as the rights of the child, should be considered in the debate of childhood vaccination. Research, policy, and parental education strategies should also take ethical implications into account to encourage well-informed policy and parental decision-making.