Reaching Families with Immunizations: Outreach Clinics and Reminder/Recall Activities for WIC Participants

Background:  The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) partners with other services key to childhood well-being including immunization delivery.  When the immunization rate for Colorado’s 2-year olds fell to 50^th in the nation, we initiated WIC outreach clinics and recall activities for vaccines. 

Setting: Denver county WIC is administered at 3 Denver Health sites.  Denver Health is an integrated safety net healthcare system with a 500-bed public hospital, county Public Health Department, and community health primary care clinics spanning 8 geographic locations, serving 112,000 patients. 

Population:  The federal WIC program targets low-income, nutritionally at-risk pregnant and postpartum women, and infants and children until their 5^th birthday. Denver county WIC serves a population >16,000 participants (on average, 25% are women, 25% infants, 50% children).

Project Description:  Routine monthly outreaches are marketed and held at WIC sites, providing free vaccines on a walk-in basis.  WIC educators staff as family liaisons to Immunization Program vaccinators and clerks.  Recall activities include letters and WIC database prompts to notify parents of children past due for DTaP vaccine.  Families were surveyed from May 2007-July 2009 to determine how they learned of WIC immunization services.

Results/Lessons Learned: From 4/19/2007-3/13/2008 records for children age 12-29 months last vaccinated at a WIC outreach were assessed and 226 were sent recall letters for DTaP vaccine (range 1 – 4 letters sent).  Of those children, 44 (19%) received a DTaP within 2 months of receiving a letter.  Between 5/7/2008-7/2/2009, in addition to recall letters, WIC database prompts were also in use and there was an increase in receipt of DTaP for this group to 26%. From 12/6/2004-11/22/2010, 291 on-site WIC outreaches were held and 14,930 vaccines administered.  WIC recall letters for DTaP were associated with 19% of under-immunized children receiving vaccine, and letters with database prompts increased return for DTaP to 26%.