KEYWORDS:
Immunization Assessment, Incentives, and WIC Program

BACKGROUND:
Based on data provided by caretakers and local medical providers, children’s immunization record is assessed at certification, re-certifications and individual infant follow-ups in order to determine up-to-date status, and make referrals. Historically, the National Immunization Survey (NIS) results show the Massachusetts WIC rate for 4-3-1-3 to be significantly higher than the rate reflected in the WIC MIS data.

OBJECTIVE(S):
Improved accuracy of assessment in WIC, to be more reflective of the actual immunization rate as defined by the National Immunization Survey (NIS), utilizing two incentive initiatives to encourage better immunization data collection. Local program staff can perform more accurate assessments based on documented immunization history.

METHOD(S):
Two incentive initiatives were designed. A financial incentive – totaling $50,000 ($25,000 from the Massachusetts Immunization Program and $25,000 from the Massachusetts WIC Program) –was designated to be shared by local WIC programs that increased the percent of children with 4-3-1-3 by 15 percentage points or reached 85% as measured by WIC MIS. The second incentive is the Bring a Book-Get a Book campaign. Golden Books were given to caretakers as an incentive to bring their children’s shot records to WIC certification, re-certification and individual follow-up appointments.
A monthly retrospective report measured progress towards increasing the percent of children completing their primary series of 4-3-1-3 by age two.

RESULT(S):
Immunization coverage rates of children with 4-3-1-3 at 24 months increased by 10%, from 49% to 59%, according to WIC MIS between October 2000 and June 2001.

CONCLUSIONS(S):
Statewide implementation of a WIC immunization initiative utilizing incentives for local program staff and participants has produced outstanding results.

LEARNING OBJECTIVES:
Describe the implementation of statewide immunization initiatives within the Massachusetts WIC Program.
Understand strategies used by the Massachusetts WIC Program to increase immunization coverage and caretaker knowledge regarding the importance of maintaining an up-to-date immunization record.