In particular, rates for flu and pneumococcal vaccination, among the most effective and cost effective vaccines, are delivered to less than 63% of adults 65 years of age or older as recommended. Rates range between 48% for African-Americans and 55% for Hispanics for flu vaccination and between 39% and 42% for African-Americans and Hispanics respectively for pneumococcal vaccination. These rates are approximately 30% lower than their Caucasian counterparts.

A systematic review of published studies looking at the effectiveness of population based approaches to increasing vaccination coverage for routinely recommended vaccines, conducted by the Task Force on Community Preventive Services and coordinated with a diverse team of experts at the CDC, found a number of effective approaches. Among these are:

Client Reminder/Recall Systems: Reminding members of a target population that vaccinations are due (reminders) or late (recall). Delivered through: telephone calls, letters or post cards.

Assessment and Feedback for Providers: Retrospectively evaluating the performance of providers in delivering one or more vaccinations to a client population and providing data back to providers. Delivered through: surveys, chart reviews, payment reviews.

Provider Reminder/Recall Systems: Developing strategies to inform health care providers their patients are due (reminder) or overdue (recall) for vaccinations. Delivered through: chart stickers, computer notification, vital sign stamps, medical record flow sheets and checklists.

Patient Reminder/Recall: Sending patient a reminder (if they are due) or a recall (if they are overdue) for a vaccination. Delivered through: mail, telephone, electronic medium or combination in individual practice settings or communities.

Standing Orders: Established protocols that enable non-physician personnel to prescribe or deliver vaccinations to patients without direct physician involvement during patient visits. Effective in particular for increasing flu and pneumococcal vaccination for adults aged > 65. Delivered through: interaction with patients at time of visit in clinics, hospitals, nursing homes and other healthcare settings.

Reducing Out of Pocket Costs: Providing insurance for, reducing co-payments associated with, or offering free vaccinations. Delivered through: provision programs, insurance coverage or reduction of co-pays at the point of service.

Expanding Access: Increasing availability of vaccinations in health care settings. Delivered through: increasing or changing the hours during which services are provided, reducing the distance from the client to the setting, delivering services where not previously provided (e.g., emergency rooms, inpatient clinics), or reducing administrative barriers to obtaining services within clinics (e.g., "express-lane" vaccination services).

These findings should be used by decision makers and clinicians in delivering and/or improving vaccine delivery. The findings can be used in concert with other resources including What Works, an interactive CD on implementing effective vaccination strategies from CDC, available at www.cdc.gov/nip. A software package, Adult CASA, developed by CDC for conducting assessment and feedback is also available to assist in implementing this strategy in provider offices. For more information on the findings from the Task Force on Community Preventive Services visit www.thecommunityguide.org.

Other Immunization News

Flu Patient-Education Material Promoting "Catch-Up" Now Available: It's not too late to vaccinate against the flu. The CDC has developed new patient-education print material to encourage people who have delayed getting a flu shot to get this valuable protection. These "catch-up" posters and flyers supplement the materials that were made available in September. All of the patient-education materials for the current flu season can be viewed and reproduced directly from www.cdc.gov/nip/flu/gallery.htm. Black and white master copies of the flyers can be downloaded from this site and reproduced on an office copy machine. Commercial printers can access the .pdf PRESS files to reproduced higher quality materials, large quantities of materials, items in multiple colors, posters, or buttons. Commercial printers may also request a CD-ROM with traditional QuarkXPress 5.0 files by e-mailing NIPINFO@cdc.gov.

VAERS Program Promoted: 200,000 health care providers throughout the U.S. recently received a letter from the CDC and the Food and Drug Administration (FDA) seeking continued use and support of the Vaccine Adverse Event Reporting System (VAERS). VAERS is one cornerstone in vaccine safety monitoring by providing a central registry where providers can inform CDC and FDA about adverse events that individuals may experience following immunization. The VAERS website, www.vaers.org, provides a number of resources including:

• The Table of Reportable Events provides a list of vaccines and adverse events for which the National Childhood Vaccine Injury Act of 1986 mandates a report. Information required includes date of administration of the vaccine, vaccine manufacturer, the lot number of the vaccine and the name and contact information of the reporter.
   
• The VAERS Reporting Form may be downloaded and printed for mail or facsimile submissions.
   
• A secure web-link is available to report an adverse event online.
   
• Vaccine Safety Post-marketing Surveillance: The Vaccine Adverse Event Reporting System, a free CDC online continuing medical education program, providers further information on VAERS.

For additional information or assistance on vaccine adverse event reporting contact the AVERS Program at info@vaers.org or calling 1-800-822-7967.

National Immunization Registry Conference Highlights: The National Immunization Program hosted the 2002 Immunization Registry Conference (October 28-30, 2002) in Philadelphia, Pennsylvania. In its third year, the conference was attended by more than 450 public health professionals from throughout the United States, its territories, Canada, Ireland and Sweden. The theme of the conference was "Grow, Connect, and Protect" which reflected the collaborative efforts of stakeholder organizations dedicated to the development, implementation, operation, administration, evaluation and funding of community- and state-based immunization registries. Sponsorship and assistance were provided by the American Immunization Registry Association, Every Child by Two, the Philadelphia Department of Public Health, the Task Force for Child Survival and Development, All Kids Count, the Center for Innovation in Health Information Systems, the American Academy of Pediatrics and the Committee on Immunization Registry for Standards for Electronic Transactions.

Highlights of the 2002 Immunization Registry Conference included a keynote address by Dr. Eve Slater, Assistant Secretary of Health, US Department of Health and Human Services and plenary presenters including Dr. Louis Cooper, Past President of the American Academy of Pediatrics, Linda Wolfe, President of the National Association of School Nurses, Dr. Issac Weisfuse, Deputy Commissioner, Division of Disease Control New York City Department of Health and Mental Hygiene, and Dr. Raymond Strikas, Director, Smallpox Preparedness and Response Activity, National Immunization Program, CDC.

All of the 2002 Immunization Registry Conference plenary presentations as well as the breakout session presentations will be available for review at www.cdc.gov/nip/registry.

Upcoming Meetings/Conferences
National Immunization Conference Call for Abstracts Extended: The deadline for abstract submission for the 37th National Immunization Conference is November 22, 2002. The meeting will be held in Chicago, March 17-20, 2003. To submit an abstract, register for the conference or review general information please visit www.cdc.gov/nip/nic.