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Qualitative Analysis of Immunization Programs With Most Improved Childhood Vaccination Coverage From 2001 to 2004

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

Journal of Public Health Management & Practice:
doi: 10.1097/PHH.0b013e3181b0b8bc
Article
Abstract

State and urban immunization programs are responsible for the implementation of comprehensive programs to vaccinate populations within their geographic area. Given the variability in immunization coverage rates between geographic areas, the purpose of this two-phase study was to first identify the state and urban areas that achieved the highest increases in coverage, and then those with the highest sustained coverage, between two designated periods, and to interview key program staff members and their community counterparts to capture their perspectives on what factors may have contributed to increasing and sustaining high rates. In this article, we describe phase 1, in which we visited the seven sites that achieved the largest increases in coverage from 2001 to 2004. Results describe outcomes from the 71 semistructured key informant interviews with internal staff and external partners at the site's immunization programs. Interview transcripts were analyzed qualitatively, using a general inductive approach. Common challenges encountered among the seven sites included increasing reluctance among parents and overcoming barriers to accessing care. Common strategies to address these and other challenges included collecting and using data on immunization coverage, developing communication and education efforts, and continuously reaching out and collaborating with immunization partners. 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 provides useful and applicable information to individuals and organizations working to strengthen immunization efforts at state and local levels, particularly for those sites that are interested in focusing on strengthening the base of their program to improve their vaccination coverage levels.

Author Information

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.

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.

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: Holly Groom, 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 (HGroom@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 Roger Bernier, Office of the Director, National, Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, for his help in developing the framework for the study, and Jim Singleton and Qian Li of the Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, for conducting the analysis used to identify the study sites. They also thank the individuals working in immunizations at the state and city level who participated in the implementation of this project.

© 2010 Lippincott Williams & Wilkins, Inc.