Learning Objectives for this Presentation:
By the end of this presentation participants will be able to identify programmatic constructs used by Jefferson County Department of Health (JCDH) to facilitate childhood immunization.



Background:
1992 National Immunization Survey data indicate that the 4:3:1:3:3 immunization rate for children in Jefferson County (Birmingham), Alabama aged 19--35 months was 53.9+7.6%-- slightly lower than the national average of 55.1+ 1.4%. By 2005, the 4:3:1:3:3:1 immunization rate had reached 84.5+6.0 %-- higher than the national average of 76+ 1.1%. To determine which initiatives may have contributed to the increased immunization rates, we conducted key informant interviews with JCDH staff; reviewed childhood vaccination programmatic data; and assessed changes in state and national immunization policies.

Setting:
Birmingham, AL

Population:
Children--19-35 months

Project Description:
JCDH used a comprehensive approach to address low childhood immunization rates. In 1995 for example, they began Shepherd's Watch, a partnership between JCDH and 38 churches representing diverse racial/ethnic communities. JCDH facilitated partnerships between eight churches and five medical centers to host eight JCDH-sponsored free immunization clinics. JCDH provided Shepherd's Watch partners with quarterly updates on immunization activities and recommendations, education to over 15,000 congregants, and technical assistance on how to implement immunization follow-up programs. Other components of the comprehensive approach included improving JCDH internal capacity and data management, strategies to capitalize on state and national policy initiatives such as the Comprehensive Childhood Immunization Initiative, and community education through over 300 health fairs, school presentations, and media campaigns.

Results/Lessons Learned:
From 1995 to 2005, while immunization rates for recommended vaccines increased approximately 20% nationally, they increased >30% in Jefferson County. Contributing factors likely included the development of innovative partnerships, improved internal capacity, state and national policy initiatives, free immunization clinics, and community education. We recommend that other health departments review factors that may influence vaccination coverage. Working with faith-based/community organizations is a potentially important component of multi-factorial strategy.