5 Strategies From National Immunization Awareness Month to Boost Vaccination Rates

As National Immunization Awareness Month draws to a close, the CDC has issued a report on the current state of vaccination among adolescents in the United States. The findings, published in the Morbidity and Mortality Weekly Report (MMWR), highlight gains in coverage from 2015 to 2016 for the 3 vaccines studied. However, the report also revealed significant disparities in coverage for adolescents in poverty and in rural areas, particularly for the human papilloma virus (HPV) vaccine.

Several studies and commentaries published during National Immunization Awareness Month have addressed strategies to help decrease these socioeconomic gaps and bring the vaccine coverage rate higher. Here are 5 promising tactics discussed this month for boosting immunization rates.

1. Mapping coverage to target areas of need

This month, the American Academy of Family Physicians (AAFP) released the Immunizations Mapper, an online tool that maps important vaccine-related metrics by state. Besides comparing states’ rates of coverage by specific vaccine, patient age, or doses received, it also includes data on what types of vaccination exemptions are permitted in each state (medical, religious, and/or philosophical).

"Our intent for the map was for people to be able to advocate at the state level for better registry information and to increase those immunization rates," explained Pam Carter-Smith, MPA, clinical policies strategist in the AAFP’s Health of the Public and Science division, in an AAFP news article.

2. Reducing care delivery barriers to accessing vaccines

According to the new report in CDC’s MMWR, the rural-urban disparities in adolescent vaccination coverage could reflect differences in healthcare delivery, provider behavior, and the efficacy of immunization programs. For instance, the federal Vaccines for Children program, which provides vaccines at no cost to vulnerable children and adolescents, relies on the provider to screen for eligibility at each visit.

The report highlighted successful state and local immunization programs that have increased their areas’ coverage through efforts like provider education, community partnerships, and providing feedback to practices with low coverage levels.

3. Reframing the conversation around vaccination

Communicating with parents about vaccination decisions can be difficult for physicians, according to an article published this month in JAMA Pediatrics. The authors explained the mental processes that may make parents resistant to vaccines and recommended that providers tailor their conversations to encourage vaccination acceptance.

The article advises using presumptive communication styles that present vaccination as the expected course of action in order to preempt any hesitancy. For example, they recommend saying “It’s time for little Johnny to get vaccinated!” rather than asking “Should little Johnny get vaccinated at this visit?”

One recent study found that childhood vaccination hesitancy can have significant public health and economic consequences. A 5% decline in measles, mumps, and rubella (MMR) vaccine coverage would result in a 3-fold spike in childhood measles cases and an additional $2.1 million in costs to the public sector.

4. Harnessing community influencers to address cultural worries

In the midst of a measles outbreak in Minnesota, clinicians and public health officials have partnered with local religious leaders to educate parents on the MMR vaccine’s benefits. The Washington Post reports that anti-vaccination groups have spread fear in Minnesota’s Somali American community for years, bringing the coverage rate dangerously low, but that trend seems to be reversing since the imams have gotten involved by reassuring parents of the vaccine's safety and necessity.

“We have seen a major shift in the uptake of Somali families coming in for MMR,” Patsy Stinchfield, a pediatric nurse practitioner in charge of the outbreak response at the Children’s Minnesota hospital, told the Post.

5. Engaging at-risk patients through reminders

Adolescents with chronic diseases are often undervaccinated, despite their higher risk of vaccine-preventable infections, according to a recent study. The research, published in Vaccine, tested vaccine reminder messages with and without embedded educational information in a cohort of adolescents still requiring vaccines. Plain reminders, at least in the short-term, may be a more effective way to encourage vaccination among high-risk adolescents, the study authors concluded.

Another at-risk population that could benefit from vaccine reminders is that of childhood cancer survivors. A new study finds that these patients are significantly less likely to receive the HPV vaccination than their peers in the general population, even though the vaccine would lower their risk of developing a second cancer.