detailed data needed to stimulate and guide improvement efforts, but they are proving costly to operate and are not yet complete enough for many planned applications. Increasing public health resources in the wake of health care reform remains a challenging task.

There were also encouraging signs. With appropriate data and information tools, health care plans and individual providers are able to improve immunization rates among their pediatric and adult patients. The health care system is finding that new partners, such as pharmacists, can help meet adult immunization needs. Communities and health departments are ready to respond when pockets of need are identified. New strategies and partnerships are emerging to combine resources within the public and private sectors in ways that are flexible enough to address each community’s needs.

Workshop participants were optimistic that even if society’s continuing and significant problems such as poverty, inequity, and instability in the health care system could not be resolved, opportunities could be found to act on immunization needs. They noted that while federal assistance needs to be reliable and adequate to support local efforts, states and metropolitan areas also have important roles to play in strengthening the national immunization partnership. Creative approaches will be necessary to address persistent needs, to assure access to services while reducing reliance upon public resources, and to design new approaches that can use information resources efficiently. Strategies that persuade private health plans and providers to assume responsibility for achieving high coverage rates within the communities that they serve will be especially important in reaching national immunization goals for both children and adults.

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