Oklahoma City Indian Clinic Immunization Outreach Program

Background:
Native Americans in the central Oklahoma Native American community are at a higher risk for disease and illness than the general population that surrounds them; due in part to socio-economic factors such as higher rates of unemployment and lower education completion rates. In addition to crowded housing arrangements which often include members of extended family, Native Americans tend to find themselves living in environments that are more conducive to disease transmission.

Setting:
Oklahoma City Indian Clinic located in Oklahoma City

Population:
American Indian adolescents ages 13-17 and American Indian adults ages 65 and over who live in the Oklahoma City metropolitan area and are patients at the Oklahoma City Indian Clinic

Project Description:
The Public Health Department's Immunization Nurse began tracking patients who were not up-to-date on their immunizations during the month of August 2007. She also:
• Sent out letters to all patients who were not current on their immunizations
• Made follow-up calls to patients who did not respond to the letters
• Worked with the Diabetes Education Coordinator to reach adults who needed an influenza of pneumonia immunization
• Coordinated with local American Indian churches to immunize their elderly population
• Participated in the Clinic's annual Children's Health Fair to reach adolescents aged 11-17 who were not up to date.

Results/Lessons Learned:
Adult influenza immunization rates for adults aged 65+ rose from 33.2% in 2007 to 63.1% in 2008, and pneumovax rates for adults aged 65+ increased from 53.2% in 2007 to 81.5% in 2008. Adolescent immunization rates for patients ages 13-17 increased from 2% to 13% for varicella, 68% to 78% for Tdap, and doubled from 23% to 47% for meningococcal conjugate vaccine. A comprehensive clinical and community-wide approach increases immunization rates among American Indian adolescents and adults.