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Vaccination Strategies

This resource focuses on strategies to increase immunization rates by utilizing assessment, feedback, incentives, and exchange methods. It provides information on improving recordkeeping, recommendations, reminders/recalls, reducing missed opportunities, and addressing barriers to immunization.

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Vaccination Strategies

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  1. Vaccination Strategies Epidemiology and Prevention of Vaccine-Preventable Diseases National Immunization Program Centers for Disease Control and Prevention Revised January 2005

  2. Why Focus on Strategies to Increase Immunization? • Immunization levels not optimal • Cost-effectiveness of some strategies uncertain • Sustainable systems needed

  3. Assessment Feedback Incentives eXchange AFIX

  4. Special Characteristics of AFIX • Focuses on outcomes • Focuses on providers • Blend of advanced technology and personal interaction

  5. Assessment • Evaluation of medical records to ascertain the immunization rate for a defined group • Diagnosis of potential service delivery problems • Assessment increases awareness

  6. Feedback • Informing immunization providers about their performance • Assessment with feedback creates the awareness necessary for behavior change

  7. How to Provide Feedback • With feeling and precision • Without judgment • With confidentiality as appropriate

  8. Incentives • Something that incites to action • Vary by provider and stage of progress • Opportunities for partnership and collaboration

  9. eXchange of Information • Allows access to more experience than an individual can accumulate • Motivates improvement • Coordinates resources and efforts

  10. VFC/AFIX • Incorporate AFIX activities during VFC site visits • Combine VFC/AFIX site visits • Reduces number of visits • Extends reach of AFIX

  11. Comprehensive Clinic Assessment Software Application (CoCASA) • VFC and AFIX results • Immediate assessment results • Estimate of coverage levels • Reasons for deficiencies • Reports on patient subsets

  12. Strategies for High Immunization Levels • Recordkeeping • Recommendations and reinforcement • Reminder and recall to patients • Reminder and recall to providers • Reduction of missed opportunities • Reduction of barriers to immunization

  13. Records • Must be available at the time of the visit • Must be easy to read • Must be accurate • reflect current patient population • reflect all vaccines given

  14. Immunization Registries • Single data source for all providers • Reliable immunization history • Produce records for patient use • Key to increasing immunization levels

  15. Recommendations and Reinforcement • Recommend the vaccine • powerful motivator • patients likely to follow recommendation of the provider • Reinforce the need to return • verbal • written • link to calendar event

  16. Reminders and Recall to Patients • Reminder—notification that immunizations are due soon • Recall—notification that immunizations are past due • Content of message and technique of delivery vary • Reminders and recall have been found to be effective

  17. Reminders and Recall to Providers • Communication to healthcare providers that an individual client’s immunizations are due soon or past due • Examples • computer-generated list • stamped note in the chart • “Immunization Due” clip on chart

  18. Missed Opportunity A healthcare encounter in which a person is eligible to receive vaccination but is not vaccinated completely

  19. Reasons for Missed Opportunities • Lack of simultaneous administration • Unaware child needs additional vaccines • Invalid contraindications • Inappropriate clinic policies • Reimbursement deficiencies

  20. Strategies for Reducing Missed Opportunities • Standing orders • Provider education with feedback • Provider reminder and recall systems

  21. Reduction to Barriers to Immunization • Physical barriers • waiting time • distance • Psychological barriers • unpleasant experience • safety concerns

  22. National Immunization ProgramContact Information • Telephone 800.CDC.INFO • Email nipinfo@cdc.gov • Website www.cdc.gov/nip

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