Using newly-available data on nearly one million children in Colorado, the Colorado Children’s Immunization Coalition (CCIC) developed custom fact sheets to help each Senate and House district understand its level of community protection and identify areas for improvement.

As a statewide nonprofit organization, CCIC is dedicated to keeping Colorado kids healthy by building awareness for vaccination, educating health care providers, and advocating for policies that protect children with the goal of increasing immunization rates.

In 2014, CCIC spearheaded the passage of House Bill 14-1288 which required licensed schools and child care centers to disclose their immunization rates upon request. In 2015, Colorado Board of Health rule changes took this legislation a step further by requiring licensed schools and child care centers to report their immunization and exemption rates annually to the Colorado Department of Public Health and Environment (CDPHE), and requiring CDPHE to make this information publicly available on its website.

Despite our successes in 2014 and 2015, immunization and public health policy are continually threatened in Colorado, requiring resources and time to defend against threats to our already lenient immunization exemption policies. Additionally, legislators are increasingly exposed to vaccine misinformation from a small but vocal minority.

In an effort to proactively educate and inform legislators of the importance of high immunization coverage rates at the local level, CCIC, with support from CDPHE, created tailored fact sheets for all 65 House Districts and 35 Senate Districts in Colorado.

We began by mapping the newly-available 2016-2017 school immunization and exemption rates by House and Senate District using Tableau software, and then used the data to create visualizations with Adobe InDesign that communicate the level of risk for vaccine-preventable disease outbreaks by comparing coverage levels to Healthy People 2020 goals. Finally, we added messaging around the importance and safety of vaccination, community immunity, exemption policy, and recommendations for taking action.

CCIC introduced the fact sheets early in the session through our member communications, website, partners’ newsletters, and via hand-delivery from our contract lobbyist. In March, CCIC and Colorado Parents for Vaccinated Communities (CPVC) hosted a luncheon at the Capitol for legislators. The event provided a safe space for parents to connect with legislators and share their personal stories and reasons for supporting immunization, while CCIC handed out fact sheets and walked legislators through their district-specific immunization data.

In total, 36 legislators or their aides attended the luncheon, and an additional 64 legislators received their fact sheets from our lobbyist. The fact sheets served as a quick reference to each legislator’s own district-level immunization data and was complemented with CCIC’s comprehensive State of the State’s Immunizations report.

Based on a survey of parents CCIC conducted in 2017, we understand most parents are not immunization experts and therefore maybe hesitant to speak up with legislators about such a complex topic. These resources help advocates support their stories with data and, in the case of the luncheon, helped them to build relationships with their legislators prior to any formal “ask” on a bill.

Anecdotally, legislators and parents found the fact sheets to be very helpful, easy to digest, and visually appealing. The fact sheet webpage has been visited more than 1,000 times, and CCIC has fulfilled several requests for mailed prints. CCIC has also received requests for the fact sheet to be expanded to cover immunization and exemption rates at the child care and county levels.

The 2018 Legislative District Fact Sheet were an innovative approach to communicating complex data, and we hope to replicate this process to engage other audiences, such as school staff and parents, child care centers, and the general public.

Since the fact sheets were created and designed entirely by CCIC’s small staff, this required a heavy lift over a short period of time. Collaborating with partners who already have necessary skills and experience with a particular software or program may ease the burden and ultimately be more efficient when embarking on a novel project.

The success of the fact sheets was multi-faceted, relying on expertise from our partners in medicine, policy, public health, and data analytics to create a relevant and impactful education tool. Moving forward, we will continue to enlist the aid and input of our many partners and members, approach legislators early in the session to build a foundation for later legislation, and employ evidence-based messaging tactics.

For more information about CCIC and our programs, please visit childrensimmunization.org.