Vaccination Strategies
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Transcript of Vaccination Strategies
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Vaccination Strategies
Epidemiology and Prevention of Vaccine-Preventable Diseases
National Immunization ProgramCenters for Disease Control and Prevention
Revised January 2005
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Why Focus on Strategies to Increase Immunization?
• Immunization levels not optimal
• Cost-effectiveness of some strategies uncertain
• Sustainable systems needed
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Assessment
Feedback
Incentives
eXchange
AFIX
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Special Characteristics of AFIX
• Focuses on outcomes
• Focuses on providers
• Blend of advanced technology and personal interaction
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Assessment
• Evaluation of medical records to ascertain the immunization rate for a defined group
• Diagnosis of potential service delivery problems
• Assessment increases awareness
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Feedback
• Informing immunization providers about their performance
• Assessment with feedback creates the awareness necessary for behavior change
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How to Provide Feedback
•With feeling and precision
•Without judgment
•With confidentiality as appropriate
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Incentives
• Something that incites to action
• Vary by provider and stage of progress
• Opportunities for partnership and collaboration
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eXchange of Information
• Allows access to more experience than an individual can accumulate
•Motivates improvement
• Coordinates resources and efforts
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VFC/AFIX
• Incorporate AFIX activities during VFC site visits
• Combine VFC/AFIX site visits
• Reduces number of visits
• Extends reach of AFIX
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Comprehensive Clinic Assessment Software Application (CoCASA)
• VFC and AFIX results
• Immediate assessment results
• Estimate of coverage levels
• Reasons for deficiencies
• Reports on patient subsets
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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
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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
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Immunization Registries
• Single data source for all providers
• Reliable immunization history
• Produce records for patient use
• Key to increasing immunization levels
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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
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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
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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
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A healthcare encounter in which a person is eligible to receive vaccination but is not vaccinated completely
Missed Opportunity
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Reasons for Missed Opportunities
• Lack of simultaneous administration
• Unaware child needs additional vaccines
• Invalid contraindications
• Inappropriate clinic policies
• Reimbursement deficiencies
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Strategies for Reducing Missed Opportunities
• Standing orders
• Provider education with feedback
• Provider reminder and recall systems
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Reduction to Barriers to Immunization
• Physical barriers
–waiting time
–distance
• Psychological barriers
–unpleasant experience
–safety concerns
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National Immunization ProgramContact Information
• Telephone 800.CDC.INFO
• Website www.cdc.gov/nip