Closing the Gap
Achieving coverage rate increases
Our destinations
Slide Pictures
How the itinerary 
was chosen
•	Grantees with greatest absolute % increase in coverage levels from 2001 to 2004 NIS were defined as “most improved” and received awards at NIC 2006

•	Visited all 7 awardees between September and November 2006
Study Objectives
•	Meet with key staff and external partners

•	Identify program characteristics and interventions that led to increased childhood immunization coverage levels 

•	Find common themes and share information with all grantees
What we heard…
Slide pictures
Starting at the top
•	Leadership is everything
•	Identify trusted immunization leaders to continually promote importance of vaccination:
– Political (governor, mayor, congress member, secretary of health, etc)
– Medical provider (AAP member, local respected private physician)
The importance 
of “culture”
•	Know your community

•	Understand local attitudes and values
– Public health
– Medical practice
– Community 

Ah, relationships…
•	Reach out and partner:
– WIC practices                    – Private practices
– AAP/AAFP		             – Hospitals
– MCOs	                                – Universities
– Schools/daycares              – Parent groups
– Media reps.			    – Pharm. reps
•	Build a coalition that extends access into your communities
Raising provider 
awareness
•	Evaluate your VFC and AFIX programs
– What is working? What could be better?
•	Use VFC and/or AFIX visits to develop relationships with private practices
•	Take all opportunities to educate 
•	Be a resource, not a regulator
•	Be accessible and responsive
Slide data

What’s passion got 
to do with it?
•	Devotion to the cause
•	Like who?
– Internal staff at all levels
– External partners: Coalition leaders, local practitioners, organizations, and service clubs (Kiwanis, Rotary)
•	You can’t teach passion, but you can find it in your community

Maintaining visibility
•	Through……
– Good leadership
– Understanding your environment 
– Strong partners/collaborators
– Raising awareness
– Using data
– Devoted staff and community members
Challenges we 
all face
•	Could the immunization schedule be any more confusing?
•	Getting accurate records & timely entry of data 
•	Access to provider offices (AFIX visits)
•	Exemptors
•	Immunization fatigue
•	Working with daycare providers
•	Reimbursement for providers 
Next steps (2007)
•	Visit programs with consistently high coverage levels
– Identify factors that make that possible

•	Visit program with lower coverage levels
– Understand their barriers and challenges