Achieving coverage rate increases

Closing the Gap

Our destinations

How the itinerary was chosen

• Grantees with greatest absolute % increase in coverage levels from 2001 to 2004 NIS were defined as “most improved” and received awards at NIC 2006

• Visited all 7 awardees between September and November 2006

Study Objectives

• Meet with key staff and external partners

• Identify program characteristics and interventions that led to increased childhood immunization coverage levels

• Find common themes and share information with all grantees

What we heard…

What we heard…

Starting at the top

• Leadership is everything• Identify trusted immunization leaders to

continually promote importance of vaccination:– Political (governor, mayor, congress member,

secretary of health, etc)

– Medical provider (AAP member, local respected private physician)

The importance of “culture”

• Know your community

• Understand local attitudes and values

– Public health

– Medical practice

– Community

Ah, relationships…

• Reach out and partner:– WIC practices – Private practices

– AAP/AAFP – Hospitals

– MCOs – Universities

– Schools/daycares – Parent groups

– Media reps. – Pharm. reps

• Build a coalition that extends access into your communities

• Evaluate your VFC and AFIX programs– What is working? What could be better?

• Use VFC and/or AFIX visits to develop relationships with private practices

• Take all opportunities to educate • Be a resource, not a regulator• Be accessible and responsive

Raising provider awareness

Data, data, data

What’s passion got to do with it?

• Devotion to the cause• Like who?

– Internal staff at all levels

– External partners: Coalition leaders, local practitioners, organizations, and service clubs (Kiwanis, Rotary)

• You can’t teach passion, but you can find it in your community

Maintaining visibility

• Through……– Good leadership

– Understanding your environment

– Strong partners/collaborators

– Raising awareness

– Using data

– Devoted staff and community members

Challenges we all face

• Could the immunization schedule be any more confusing?

• Getting accurate records & timely entry of data • Access to provider offices (AFIX visits)• Exemptors• Immunization fatigue• Working with daycare providers• Reimbursement for providers

Next steps (2007)

• Visit programs with consistently high coverage levels– Identify factors that make that possible

• Visit program with lower coverage levels– Understand their barriers and challenges