Overcoming Barriers to Immunization A Workshop Summary (1994) / Chapter Skim
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3 LEADERSHIP FOR ACTION ON IMMUNIZATION
3 LEADERSHIP FOR ACTION ON IMMUNIZATION
Pages 24-33
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From page 24... ...
The committee believes that stronger leadership must be exercised at the federal, state, and local levels and in the public and private sectors to build a comprehensive and collaborative primary care system that can improve the delivery of immunization services. Notable advances in immunization coverage rates and disease reduction have been made when strong leadership was exerted at all levels, clear targets were set, a comprehensive strategy was formulated, and accountability in implementation was monitored.
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From page 25... ...
Strategies for comprehensive immunization coverage for preschool children have proved more elusive. Among these children, there is no universal experience equivalent to school entry, and the United States lacks the centrally managed health care system that allows the United Kingdom to exert a strong influence over local providers.
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From page 26... ...
to improve immunization levels among preschool children.2 These funds give states and urban areas the opportunity to move ahead with reducing barriers to immunization, enhancing the infrastructure for vaccine delivery, and supporting immunization information and education activities. IAPs are intended to support improvements in the delivery of public and private immunization services, but the initial focus has been on the public sector.
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From page 27... ...
CDC's role includes implementing operational aspects of the President's Childhood Immunization Initiative, administering major grant programs, providing technical assistance to public health departments in the delivery and monitoring of services, and conducting disease surveillance. CDC also coordinated the development and publication of the Standards for Pediatric Immunization Practices (CDC, 1993b)
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From page 28... ...
reducing cost barriers through the Vaccines for Children Program, under which the federal government will purchase vaccines for Medicaid-eligible and uninsured children · improving disease surveillance and measurement of immunization coverage at the national, state, and local levels and by individual providers coordinating immunization activities among federal departments and agencies and promoting partnerships with private providers and organizations . · encouraging the development of safer and more effective vaccines, including combination products that can reduce the number of separate vaccine doses required SOURCE: CDC (1994b)
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From page 29... ...
Financial constraints at state and local levels and steady or declining funds from federal sources have made it difficult for health departments to meet the increasing demand for public immunization services caused by referrals from private providers (Schulte et al., 1991~. Some assistance should come from an increase of $83 million in federal funding through IAPs in fiscal year 1994 and, beginning in October 1994, expanded purchase of vaccines by the federal government for Medicaid-eligible and uninsured children, including those cared for by private providers.
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From page 30... ...
Rita Goodman, from the Bureau of Primary Health Care in HRSA, noted that a study of five community and migrant health centers showed better immunization coverage in the center that immediately identified children seeking immunizations and referred them to special providers at the center. Adopting standing orders that authorize nurses to immunize children also is associated with higher immunization rates.
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From page 31... ...
The program also includes education and immunization services at some sites. Maryland has taken a more controversial approach: reducing monthly AFDC grants if children lack evidence of prescribed preventive care visits.
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From page 32... ...
The revised guidelines sanction a minimal set of valid contraindications to immunization. Second, an extensive provider education program introduced the new guidelines and a revised immunization schedule.
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From page 33... ...
Professional advertising agencies developed the television spots used in the campaign. Because the television districts and health districts cover very similar regions, it has been possible to target the immunization message to those districts with lower immunization rates.
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