KEYWORDS:
Immunization, Community-Based Outreach

BACKGROUND:
Beginning at birth and continuing through 19 months of age, infants routinely require the complete primary schedule of vaccinations for hepatitis B, diphtheria, tetanus, pertussis, polio, measles, mumps, rubella, varicella (chickenpox), Haemophilus influenzae type b (Hib), and Streptococcus pneumoniae disease, requiring at least four doctor’s visits. Approximately 25% of infants do not complete their primary vaccination schedule by their 2nd birthdays; poverty and associated life difficulties are the primary risk factors for under-immunization.

OBJECTIVE:
To assess a community-based outreach program intended to refer to care infants who are immunized-delayed and live in impoverished communities.

METHOD:
The Philadelphia Department of Public Health (PDPH) contracts with three community-based organizations (CBO’s) in the impoverished communities of Philadelphia to outreach families with immunization-delayed infants, as identified by the PDPH Kids Immunization Database/Tracking System (KIDS) Registry. CBO staff provides comprehensive case management to families to overcome barriers to immunization.

RESULT:
During 2001, the KIDS Registry generated 8,248 referrals for case management of immunization-delayed infants by CBO staff. CBO staff located 7,039 (85%) cases, assessed 50% (3,542) as completely vaccinated, successfully referred 31% (2,189) for needed vaccination(s), and were unsuccessful with the remaining 19% (1,308) due to refusal of family or health care provider to cooperate with the referral.

CONCLUSION:
Approximately 25% of infants less than 2 years of age lack primary vaccination(s), and these children are disproportionately impoverished. Collaboration between PDPH and CBO’s serving impoverished communities is effective in significantly improving infant immunization rates in these high-risk communities, thus preventing disease outbreaks.

LEARNING OBJECTIVES:
To learn about how community-based outreach can effect immunization levels in high-risk neighborhoods. To learn specific strategies and lessons about culturally-sensitive outreach.