BACKGROUND:
The burden of adult vaccine-preventable diseases in the U.S. is staggering - 36,000 deaths and 114,000 hospitalizations annually from influenza and pneumonia, with most occuring in persons 65 years of age and older. Vaccination rates for this population for both influenza and pneumococcal vaccines are well below the HP2010 goal of 90%, and even lower for African-American and Hispanic elderly. Little is known about succesful interventions to raise immunization coverage in these minority populations.

OBJECTIVE:
READII (pronounced "ready")project goals are to learn more about effective interventions in minority adult populations, to raise adult influenza and pneumococcal immunization levels, and ultimately to reduce/eliminate these health disparities.

METHOD:
Programmatic strategies include: (1) improve provider vaccination practices, increase access, & increase demand; (2) target multiple provider groups/systems; (3) tailor specific interventions to local needs/capacity; and (5) determine feasibility/sustainability & potential impact

RESULT:
This demonstration project is being conducted in 5 sites (Chicago; Milwaukee; San Antonio; Rochester, NY and 19 [Delta Region] counties in Mississippi) and will run through 12/31/2004, with evaluation activities taking place in early 2005. Preliminary results suggest that adult providers are hard to reach/motivate and may resist proven interventions such as standing orders. Nursing & other ancillary health care workers' negative attitudes and mis-conceptions about these vaccines may contribute to low uptake among patients. Health care workers themselves are poorly immunized. Venues to vaccinate target populations in the ZIP codes where they live are often not available (i.e., supermarkets, pharmacies, senior centers have closed/moved). Some providers, though aware of Medicare's reimbursement for the cost/administration of these vaccines, cannot front the cost to purchase them and risk waste. The message to get immunized to protect not only oneself, but one's loved ones (granchildren, etc.) appears to resonate with elderly minority populations.

CONCLUSION:
This demonstration project is on-going. Evaluation efforts will take place in early 2005; therefore, no conclusions are yet available.

LEARNING OBJECTIVES:
Participants should be able: (1) to describe the influenza and pneumococcal vaccination disparities among minority elderly; (2) to list/describe 2-3 interventions being used by the READII demonstration sites; and (3) to relate 1-2 preliminary findings of the READII project efforts to date.