Improving Immunization Rates among WIC Clients: How an immunization registry helped

Learning Objectives for this Presentation:
By the end of the presentation participants will be able to describe how the Oregon WIC and Immunization Programs leveraged the federal mandate and the immunization registry to improve rates.

Background:
Immunization screening of 3-24 month old WIC clients has been federally required since October 2002. The state WIC-Imm Team developed trainings and tools for local implementation. Basic training followed the minimum requirements to count DTaP; additional tools included access to data from the ALERT immunization registry and electronic forecasting.

Objectives:
1. To describe the implementation of the federal screening mandate.
2. To describe changes in screening practices by WIC Agencies and changes in immunization rates among WIC clients.

Methods:
Annually since 2004, WIC-Imm surveyed local WIC agencies about: screening methods for WIC clients (ie., counting DTaP or full review); type of records reviewed; referral practices; and incentives. For this same time period, immunization rates by county for WIC and non-WIC populations were produced using immunization registry data adjusted for child mobility and incomplete provider reporting.

Results:
All 34 local WIC agencies completed the surveys in 2004-2006 reporting that changes in screening method were minimal; however the records reviewed changed considerably. In 2004, 10 agencies (29%) reported reviewing the client's electronic immunization record, which increased to 19 agencies (56%) in 2006. Likewise those reporting any reliance on an electronic forecast process increased from 7 (21%) in 2004 to 20 (59%) in 2006. The population-based immunization rates for Oregon WIC clients showed a similar trajectory from 68.5% in 2004 to 71.1% in 2006, compared to 70.0% to 70.9% among non-WIC participants (note all confidence intervals approximately 0.6%).

Conclusions:
Oregon's WIC-Imm Team successfully used registry tools to improve immunization screening for WIC children and to measure immunization rates across the population. Expanded forecasting tools in 2007 will standardize more complete record review and appropriate referrals.