|
Intervention |
Recommendation |
Intervention
Description |
|
Increasing
community demand for vaccinations |
|
Client
reminder/recall |
Strongly
recommended |
Reminders that
vaccinations are due (reminders)
or late (recall) are provided to
target populations.
Delivery
techniques include telephone
calls, letters, or postcards;
contents of messages vary. |
|
Multicomponent
interventions that include
education |
Strongly
recommended |
Target
populations receive education
regarding vaccinations.
Vaccination
providers might also receive
education.
Used with at
least one other activity to
improve vaccination rates. |
|
Vaccination
requirements for child care,
school, and college attendance |
Recommended |
Laws or policies
are enacted or enforced that
require vaccinations or other
documentation of immunity as a
condition of attendance. |
|
Community-wide
education only |
Insufficient
evidence* |
Provides
information to a target population
in a geographic area.
Can also provide
information to vaccination
providers.
Does not include
other features (e.g., reminders),
activities, or efforts limited to
specific settings. |
|
Clinic-based
education only |
Insufficient
evidence* |
Provides
information to persons served in a
specific medical or public health
clinical setting.
Does not include
other features (e.g., reminders)
or activities provided in other
settings (e.g., school or child
care centers). |
|
Client or family
incentives |
Insufficient
evidence* |
Provides
financial or other incentives to
motivate acceptance of
vaccinations.
Incentives can
involve either rewards or
penalties.
(Interventions
with aspects of incentives (e.g.,
WIC programs or vaccination
requirements for child care,
school, or college attendance) are
categorized elsewhere.) |
|
Client-held
medical records |
Insufficient
evidence* |
Provides to
clients or family members medical
records that indicate which
vaccinations have been received. |
|
Enhancing access
to vaccination services |
|
Reducing
out-of-pocket costs |
Strongly
Recommended |
Can include
providing free vaccinations or
administration, providing
insurance coverage, or reducing
co-payments for vaccinations at
the point of service. |
|
Expanding access
in health-care settings |
As
part of a multi-component
intervention -
Strongly recommended
Alone
- Insufficient evidence |
One or more of
the following:
Reduces the
distance from the setting to the
population.
Increases or
makes more convenient the hours
during which vaccination services
are provided.
Delivers
vaccinations in clinical settings
in which they were not provided
previously (e.g., inpatient
units).
Reduces
administrative barriers to
obtaining vaccination services
within clinics (e.g., "drop
in" clinics or an
"express lane"
vaccination service. |
|
Vaccination
programs in WIC settings |
Recommended |
Encourages the
vaccination of low-income clients
of this non-medical setting.
At a minimum,
requires assessment of each
child's immunization status and
referral of under-immunized
children to a health-care
provider. |
|
Home visits |
Recommended |
Provides
face-to-face services to clients
in their homes.
Services can
include education, assessment of
need for vaccinations, referral
for vaccinations, or provision of
vaccinations.
Can also include
telephone or mail reminders. |
|
Vaccination
programs in schools |
Insufficient
evidence* |
Intended to
improve delivery of vaccinations
to school attendees aged
approximately 5-18 years.
Usually includes
vaccination-related education of
students, parents, teachers, and
other school staff and either
provision of vaccinations or
referral for vaccinations.
Can also include
incentives to participants and
methods for acquiring written
consent from parents.
(Laws requiring
vaccination for school entry are
evaluated elsewhere) |
|
Vaccination
programs in child-care centers |
Insufficient
evidence* |
Encourages the
vaccination of children aged <5
years.
Requires
assessment of each child's
immunization status at entry into
child-care or at some point during
child's enrollment.
Can also involve
additional assessments at periodic
intervals, education or
notification of parents, referral
of under-immunized children to a
health-care provider, or provision
of vaccination on-site.
(Laws requiring
vaccination for child-care centers
are evaluated elsewhere) |
|
Provider-based
interventions |
|
Provider
reminder/recall |
Strongly
recommended |
Informs those
who administer vaccinations that
individual clients are due
(reminder) or overdue (recall) for
specific vaccinations.
Techniques by
which reminders are delivered:
client charts, computer, mail, or
other; content of the reminders
vary
(Interventions
that incorporate elements of
reminders and standing orders are
reviewed with standing orders) |
|
Assessment and
feedback for vaccination providers |
Strongly
recommended |
Involves
retrospectively evaluating the
performance of providers in
delivering one or more
vaccinations to a client
population and giving this
information to the providers.
Can also include
other activities (e.g., incentives
or benchmarking: comparing
performance to a goal or
standard). |
|
Standing orders |
For
adults
- Strongly recommended
For children
- Insufficient evidence* |
Non-physician
medical personnel prescribe or
deliver vaccinations to client
populations by protocol without
direct physician involvement at
the time of the interaction.
Settings include
clinics, hospitals, and nursing
homes.
(Dedicated
vaccination clinics often operate
under standing orders, but these
were not considered to be an
intervention for the purposes of
this chapter.) |
|
Provider
education only |
Insufficient
evidence* |
Provides
information to vaccination
providers to increase their
knowledge or change attitudes.
Techniques can
include written materials,
lectures, continuing medical
education programs, and
computerized software. |
