Comprehensive Community-Based Pre-School Immunization Compliance Initiative

Background:
In 2006, the Pre-School Immunization Program was implemented as an intervention funded by the Washington, DC Department of Health to increase immunization compliance among pre-school children. The goal was to increase compliance by15%.

Setting:
The Pre-School Immunization Program provides direct services via a fully equipped and staffed mobile unit.

Population:
The intervention is targeted to children in Head Start centers, licensed childhood development centers, and licensed before and after childcare providers, and parents.

Project Description:
Computers on the mobile unit allow real-time access to the Immunization Registry. Children are provided free vaccinations. Parents/guardians receive comprehensive healthcare information and if applicable, assistance in establishing a medical home. All immunizations administered on the unit are submitted within twenty-four (24) hours to the city's registry.
We developed an intra-institutional partnership with the city's largest pediatric clinic to identify and implement best practice initiatives to improve the immunization rate by immunizing children during well and sick child visits, and sending records to the registry timely. Service providers and parents/guardians are educated through our community education initiative that provides various educational resources including Immunizations/Primary Care, Cardiopulmonary Resuscitation (CPR), Infant Care, and Babysitting classes.

Results/Lessons Learned:
The immunization compliance rate increased after one year by 7.41% and 6.02% for Head Starts and Licensed Childhood Development Centers, respectively, and after two years by 15.11% increase and a 16.7%, respectively. Annually, the program reaches more than 5, 000 people through direct services and education. In addition to direct care services, the need to educate parents/guardians, service providers, and medical professionals is critical in sustaining immunization compliance rates. Non-traditional approaches should be identified to provide services and link families considered “hard to reach” to a medical home. Additionally, working with government agencies to implement and enforce mandates is a significant aspect to the success of the program.