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Use this Handy Checklist to Help Improve your Practice’s Vaccination Rates

December 2014

Technically Speaking

Monthly Column by Deborah Wexler, MD

Technically Speaking is a monthly column written by IAC’s Executive Director Deborah Wexler, MD. The column is featured in The Children’s Hospital of Philadelphia Vaccine Education Center’s (VEC’s) monthly e-newsletter for healthcare professionals. Technically Speaking columns cover practical topics in immunization delivery such as needle length, vaccine administration, cold chain, and immunization schedules.

Check out a recent issue of Vaccine Update for Healthcare Providers. The VEC e-newsletter keeps providers up to date on vaccine-related issues and includes reviews of recently published journal articles, media recaps, announcements about new resources, and a regularly updated calendar of events.

TECHNICALLY SPEAKING

Use this Handy Checklist to Help Improve your Practice’s Vaccination Rates

Published December 2014

Information presented in this article may have changed since the original publication date. For the most current immunization recommendations from the Advisory Committee on Immunization Practices, visit www.immunize.org/acip/acip_vax.asp.

We all know that vaccines are cost-effective, safe and life-saving. But sometimes, competing priorities in a busy medical practice can push vaccines off the radar during office visits. This can contribute to low vaccination rates, leaving our patients unprotected against preventable diseases.

Vaccination rates in teens and adults are appallingly low. According to recent statistics from the Centers for Disease Control and Prevention (CDC), completion rates for three doses of human papillomavirus (HPV) vaccine for 13- to 17-year-old females (recommended in 2007) have plateaued at 37.6 percent; for males in the same age range (recommended in 2010), the completion rate is a dismal 13.9 percent. Two doses of meningococcal conjugate vaccine (MCV4) have been recommended for teens ages 11 to 18 since 2011, yet only 29.6 percent have completed the two-dose series.

Adults fare even worse. Tdap (tetanus, diphtheria, pertussis) vaccine for adults age 19 to 64 (recommended in 2007) has a coverage rate of only 15.6 percent, and zoster (shingles) vaccine for those age 60 and older (recommended in 2008) has only reached 20.1 percent of that age group.

What can you do?

Be sure you are taking steps in your practice to help your staff administer recommended vaccines on time! Need help? The Immunization Action Coalition has developed a clear, step-by-step, three-page checklist, Suggestions to Improve Your Immunization Services, that contains more than 35 ideas that medical practices can use to improve their immunization delivery. As highlighted below, these ideas are conveniently grouped under eight different categories:

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Keeping clinic staff up to date with current recommendations. For example, you can:

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Post the U.S. official immunization schedules in exam rooms and adhere to the recommendations.

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Use the “catch-up” schedules when patients fall behind.

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Know about vaccination needs of high-risk patients.

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Assuring complete, up-to-date patient records. Examples include:

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Participate in your state immunization registry.

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Ask your patients about vaccinations received outside your office.

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Review vaccination records each time your patient comes in.

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Maintaining and protecting your vaccine supply. Make sure that:

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There is a designated vaccine storage and handling coordinator in your office.

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All staff is trained in how to safeguard your clinic’s vaccine supply.

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Getting patients ready for their vaccinations. You can:

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Have your patients fill out screening checklists for vaccine contraindications before you see them, which will save you time.

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Assure all medical and office staff are trained to recognize true vaccine contraindications so they do not miss opportunities to vaccinate.

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Hand out Vaccine Information Statements (VISs) once you’ve assessed which vaccinations are needed and give VISs to patients ahead of time so they have time to read them.

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Assuring complete, up-to-date patient records. Examples include:

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Participate in your state immunization registry.

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Ask your patients about vaccinations received outside your office.

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Review vaccination records each time your patient comes in.

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Avoiding “missed opportunities.” Take time to:

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Review immunization records prior to the patient visit to “flag” the record if vaccines are due/overdue.

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Recommend that your patients receive ALL vaccines that are needed at the time of the visit. Don’t delay or postpone them unless there is an appropriate reason to do so.

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Improving access to clinic services. Ideas include:

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Consider making vaccinations available during evenings or weekends.

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Provide walk-in “nurse only” visits for vaccinations.

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Use standing orders when appropriate to expedite vaccine delivery.

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Communicating with patient. Be sure to:

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Give handouts to patients showing the vaccination schedule recommended for them.

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Give them a copy of their immunization record each time they receive vaccines.

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Tell them when their next doses are due.

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Evaluating and improving your clinic’s performance. Establish systems to:

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Assess your clinic’s records to confirm that you are vaccinating your patients appropriately and on schedule (your state/local immunization program staff may be able to provide assistance in this assessment or offer tools you can use yourself).

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Enroll in the Vaccines for Children (VFC) program, if you have not already done so.

Download Suggestions to Improve Your Immunization Services today and use these practical ideas to help you determine where improvements might be made in your delivery of immunization services.

Here are more resources to help you.

Vaccine schedules, guidance, and clinic tools

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