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A Qualitative Analysis of Immunization Programs With Sustained High Coverage, 20002005

Kennedy, Allison MPH; Groom, Holly MPH; Evans, Victoria BS; Fasano, Nancy MA

Journal of Public Health Management & Practice:
doi: 10.1097/PHH.0b013e3181c7e053
Article
Abstract

Despite record-high immunization coverage nationally, there is considerable variation across state and local immunization programs, which are responsible for the implementation of vaccine recommendations in their jurisdictions. The objectives of this study were to describe activities of state and local immunization programs that sustained high coverage levels across several years and to identify common themes and practical examples for sustaining childhood vaccination coverage rates that could be applied elsewhere. We conducted 95 semi-structured key informant interviews with internal staff members and external partners at the 10 immunization programs with the highest sustained childhood immunization coverage from 2000 to 2005, as measured by the National Immunization Survey. Interview transcripts were analyzed qualitatively using a general inductive approach. Common themes across the 10 programs included maintaining a strong program infrastructure, using available data to drive planning and decision making, a commitment to building and sustaining relationships, and a focus on education and communication. Given the challenges of an increasingly complex immunization system, the lessons learned from these programs may help inform others who are working to improve childhood immunization delivery and coverage in their own programs.

In Brief

This article describes activities of state and local immunization programs that sustained high-coverage levels across several years and identifies common themes and practical examples for sustaining childhood vaccination coverage rates that could be applied elsewhere.

Author Information

Allison Kennedy, MPH, is Epidemiologist, National Center for Immunization and Respiratory Diseases, Immunization Services Division, Health Services Research and Evaluation Branch, Centers for Disease Control and Prevention, Atlanta, Georgia.

Holly Groom, MPH, is Epidemiologist, National Center for Immunization and Respiratory Diseases, Immunization Services Division, Health Services Research and Evaluation Branch, Centers for Disease Control and Prevention, Atlanta, Georgia.

Victoria Evans, BS, is Health Communication Specialist, National Center for Immunization and Respiratory Diseases, Immunization Services Division, Education, Information, and Partnerships Branch, Centers for Disease Control and Prevention, Atlanta, Georgia.

Nancy Fasano, MA, is Branch Chief, National Center for Immunization and Respiratory Diseases, Immunization Services Division, Program Operations Branch, Centers for Disease Control and Prevention, Atlanta, Georgia.

Corresponding Author: Allison Kennedy, MPH, Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS E-52, Atlanta, GA 30333 (AKennedy@cdc.gov).

Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

The authors thank Zhen Zhao and Jim Singleton of the Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, for conducting the trend analysis that was used to identify the study sites, and Roger Bernier, Office of the Director, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, for his input on the project aims and methods. We also thank the program staff and community partners who shared their time and insights with us.

© 2010 Lippincott Williams & Wilkins, Inc.