Vaccinating Uninsured and Underinsured Adult In Minnesota

Background: There is no federal program to cover immunizations for uninsured and underinsured adults like the Vaccines for Children Program. In the past, Minnesota has provided limited vaccines for select adult populations to public clinics but the amount of vaccine available and who was eligible was inconsistent, resulting in confusion for providers and the public. As a result, in November 2010, the Minnesota Department of Health (MDH) created the Uninsured and Underinsured Adult Vaccine (UUAV) program, a consistent program to serve this population.

Setting: 109 selected organizations in Minnesota.

Population: Uninsured and underinsured adults.

Project Description: MDH put out a request for proposals for any organization that regularly sees uninsured and underinsured adults.  The program was designed to provide consistency for a three year time period (January 2011-December 2013).  Over 160 proposals were received requesting more than $10 million worth of vaccine over the three year period.  Clinics were selected based on the duration of their adult immunization program, percentage of uninsured and underinsured adult patients served, planned outreach and statewide geographic representation.

Results/Lessons Learned:  A total of $1.5 million in vaccine was awarded to the 109 organizations selected for the UUAV program.  Awards were based on the needs described in each proposal.  Selected organizations were listed on a website so patients could search by county. Throughout 2011, $897,000 in vaccine was ordered.  Many doses of vaccine were ordered and administrated to the uninsured and underinsured population in 2011 through this program.  However, many doses went un-ordered. MDH plans to organize more outreach aimed at both providers and the general public. After the first of three years of the UUAV program, it became clear that uptake for adult vaccines is unpredictable. Increased efforts for staff education and patient promotion are necessary to enhance the ability of these sites to use all doses of vaccine available to them.