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Strategies to Reach Uninsured Adults with Vaccination

July 19, 2017

Toolkit for Health Departments and Medical Practices

According to data from the 2012 National Health Interview Survey, adult vaccination coverage remains low for most routinely recommended vaccines resulting in tens of thousands of deaths from vaccine-preventable diseases. While there are federal programs that remove most financial barriers to vaccination for children, there are fewer programs for adults, and uninsured and underinsured adults may not be able to access or afford out-of-pocket costs for needed vaccines. Despite implementation of the federal Affordable Care Act (ACA), an estimated 14% of adults remain uninsured and experience substantial barriers to immunization services.

In an effort to increase the number of uninsured and underinsured adults that get vaccinated, the Association of State and Territorial Health Officials (ASTHO), in conjunction with the Centers for Disease Control and Prevention (CDC), selected JSI to create the Identifying And Vaccinating Uninsured Adults - Strategies and Practices toolkit. The toolkit includes strategies, practices, and resources from 13 selected state and local health department immunization programs and their partners that have implemented activities or programs to improve access to vaccines for vulnerable adult populations.

JSI conducted key informant interviews with state and local immunization programs and their community partners to identify effective strategies for identifying and vaccinating uninsured and underinsured adults. State immunization managers were recruited through various professional groups such as the National Adult Immunization Coordinators, the Association of Immunization Managers, and at the recommendation of the CDC. Community partners consisted of local health departments, community health centers, and clinics that serve uninsured populations. Based on information from the interviews, summary “stories” were developed describing specific activities, experiences, lessons learned, and recommendations.

Several story highlights include:

  • Georgia has time-tested experience in strategic engagement of partners.
  • Michigan’s use of immunization champions ensures that all staff are knowledgeable and vaccine protocols are followed.
  • North Carolina works across state systems to ensure vaccinations are provided despite life circumstances.
  • Oregon provides mini-grants to support local partners to implement innovative activities to vaccinate adults.
  • Rhode Island supplements Section 317-funded vaccines with replacement doses from pharmaceutical company patient assistance programs that extend vaccine dose availability for uninsured.
In addition to the stories, a summary of strategies and practices, and resources are also provided in the toolkit.

Learn more about JSI’s role in helping to reach uninsured/underinsured adults with vaccination or to learn more about our other immunization work, visit: JSI’s Immunization Work Overview.