KEY ACTIVITY #16:
Offer Nonpractice-Based Access to Immunizations
This key activity involves all seven elements of person-centered population-based care: operationalize clinical guidelines; proactive patient outreach and engagement; address social needs.
Overview
Reliable, timely access to immunizations remains difficult for many patients and families for a variety of reasons. During the COVID-19 pandemic, childhood immunization rates declined, particularly for children in families living below the federal poverty limit and in rural areas. Practices can consider promoting vaccinations at community-based pharmacies or developing mobile vaccination centers as potential strategies to provide access to recommended immunization for children and youth.
Leveraging this intervention to improve equitable health outcomes and social needs
Children from families with lower socioeconomic status are less likely to complete all well-child visits (WCVs) and therefore less likely to benefit from vaccination strategies that revolve around use of WCVs. Providing alternate means for vaccination reduces barriers to access and can contribute to mitigating inequities in health and well-being experienced by children based on race, ethnicity, and class. This intervention may be particularly relevant for children living in rural areas, given that they have experienced lower childhood immunization rates than children living in non-rural areas.
Implementation tips
Pharmacy-based vaccinations: In many communities, pharmacies are widely and consistently accessible. In California, pharmacists may administer vaccines for persons three years of age and older if they meet certain requirements. Pharmacies must enter the immunization data into CAIR and inform the PCP within 16 days.[1]
One positive side effect from the COVID-19 pandemic is that more individuals and families are accustomed to receiving immunizations from a local pharmacy. Pharmacies are allowed to enroll in the Vaccines For Children program and administer childhood vaccines (three to 18 years) through 2024 as a result of the 2020 Public Readiness and Emergency Preparedness (PREP) Act.
Mobile vaccination centers: Tips and resources for designing and planning mobile vaccination are available through multiple sources, including the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC), among other organizations. Additionally, learn from others who have developed and executed similar interventions.
- The AAP offers guidance and supports, including but not limited to Planning an Influenza Vaccination Clinic and Checklist for Planning and Implementing a Flu Vaccination Clinic.
- The CDC also offers guidance and support, including but not limited to Planning Activities, Considerations for Planning Curbside and Drive-Through Vaccination Clinics, and Satellite, Temporary, and Off-Site Vaccination Clinic Supply Checklist.
- The California Department of Public Health also offers guidance and support on their website, The Immunization Branch of the California Department of Public Health.
- National Association of County and City Health Officials (NACCHO) also offers guidance and support, particularly for school-based vaccination clinics in their School-Located Vaccination Clinic Toolkit.
- The University of Minnesota National Resource Center for Refugees, Immigrants, and Migrants (NRC-RIM) provides examples of mobile vaccination as well as concrete tips and resources.
The academic literature provides evidence-based examples:
- Leibowitz A, Livaditis L, Daftary G, Pelton-Cairns L, Regis C, Taveras E. Using mobile clinics to deliver care to difficult-to-reach populations: A COVID-19 practice we should keep. Preventive Medicine Reports. 2021 Dec;24(101551):10155