IZ Survey

New NACCHO Study Shows Over a Doubling of Local Health Department Immunization Spending with Increases in Innovative Service Delivery and Outreach

Jun 06, 2024

Washington, DC, June 6, 2024 – The National Association of County and City Health Officials (NACCHO), the voice of over 3,300 local health departments across the country, released its 2023 Immunization Profile Study, showing that average expenditures more than doubled between fiscal year 2020 and fiscal year 2021, and remained constant throughout fiscal year 2022. Immunization activities have also increased, including a 34% uptick in local health departments conducting immunization-related outreach efforts over the past five years. Local health departments reported shifts in how they provide immunization access, with expanded clinic hours, use of mobile clinics, and more offering school-based immunization clinics. These changes mark important steps to increase immunization access across the country and the need for long-term support in the post-pandemic era.

The report underscores the challenges faced by local health departments since the pandemic and the need for augmented workforce capacity, improved outreach efforts to combat the rise of vaccine hesitancy, and increased investments in data modernization.

The Immunization Profile Study data show both point-in-time information, as well as longitudinal change since 2017, about local health departments’ immunization infrastructure, services, and priorities. Some key findings include:

Immunization Workforce Capacity – Half of local health departments reported limited staffing as a key challenge in conducting immunization-related services, despite the recent growth in the overall workforce driven by COVID-related funding, as reported by the 2022 National Profile of Local Health Departments Study.

  • Between 2017 and 2023, the proportion of local health departments with six or more full-time equivalents (FTEs) dedicated to immunization nearly doubled, rising from 18% to 34%. However, in 2023, local health departments had an average of only one-third of an FTE per 10,000 people in their jurisdiction. Although some agencies experienced an increase in immunization staffing, this growth is likely insufficient to meet their communities’ needs.
  • Additionally, over the past five years, local health departments reported allocating more staff time to immunization-related activities. Approximately 45% of local health departments reported spending an average of more than 20 hours per week on immunization services, an increase from 34% in spending the same amount of time in 2017.

Vaccine Uptake and Access Among local health departments’ top immunization-related priorities for the next three years are increasing vaccine uptake by bolstering vaccine confidence for youth, ages 5-18 (41%), and early childhood immunizations under 5 (39%), and conducting educational outreach efforts with community partners (37%).

  • Local health departments most frequently improved access to routine immunizations by expanding or newly implementing clinics in community settings (42%) or increasing their walk-in hours/flexible hours of operation (41%).
  • Approximately half of local health departments also partnered with either health care providers or community leaders to improve vaccination uptake.
  • The proportion of local health departments using social and/or traditional media for outreach increased to 90% in 2023 compared to 67% in 2017.
  • Despite the increased activities to expand access and messaging, most local health departments (82%) still reported that vaccine hesitancy was a barrier to conducting immunization-related activities.

COVID-19 Immunizations – Local health departments were key players in vaccinating against COVID-19 by more than doubling their spending on immunization activities and increasing access in under-resourced areas.

  • In the 2022 calendar year, 93% of local health departments provided COVID-19 vaccines to adults and 87% provided them to children and youth. On average, local health departments spent 15% of their time administering these vaccines.
  • Average local health department spending on immunization increased during the COVID-19 pandemic – more than doubling from $267,000 in FY2020 to $606,000 in FY2021. Average expenditures in FY2022 were $626,000 – an estimated 5% of average overall spending based on 2022 Profile Study data.
  • Approximately half of local health departments increased their walk-in/flexible hours of operation (51%) or clinics in community settings (48%) to improve COVID-19 vaccine access. Meanwhile, three in five local health departments increased resources to underserved areas or partnered with health care providers or community leaders to increase uptake of COVID-19 vaccinations.

Immunization Data Capacity Investing in data capacity ensures that local health department efforts are targeting under-vaccinated populations and addressing the motivations behind vaccine hesitancy; however, challenges in data capacity remain.

  • Despite large federal investments in recent years on public health data modernization, more than half of local health departments used paper records to manage immunization records and vaccine inventory, and 41% reported that interjurisdictional data sharing was a key barrier to their work.
  • Fewer prioritized improving data systems to understand coverage rates (13%), collecting data on community attitudes about vaccine uptake (12%), or updating their immunization information systems (8%).

# # #

About the 2023 Immunization Profile Study
For the 2023 survey, a total of 2,512 local health departments were included in the study population. Rhode Island was excluded from the study because the state health agency operates on behalf of local public health and has no sub-state units. A nationally representative random sample of 1,018 local health departments were invited to complete the survey. NACCHO administered the survey from January to February 2023. Overall, the survey had 422 local health departments respond, for a response rate of 41%. Responses represented local health departments in 40 states and the District of Columbia.

About NACCHO
The National Association of County and City Health Officials (NACCHO) represents the over 3,300 local governmental health departments across the country. These city, county, metropolitan, district, and tribal departments work every day to protect and promote health and well-being for all people in their communities. For more information, visit www.naccho.org.


Related Posts

Image
  • Press Release Community Health Emergency Response

NACCHO Awards $200,000 to Improve Data-Sharing...

NACCHO awards $200,000 to two local health departments to enhance data-sharing...

Jun 18, 2024

NACCHO Awards $200,000 to Improve Data-Sharing...

Website New Episode w Special Guests
  • Press Release Podcast Research & Reports

NACCHO’s Podcast From Washington: Experts Discuss...

NACCHO experts discuss important research findings from the new Forces of...

Jun 14, 2024

NACCHO’s Podcast From Washington: Experts Discuss...

Connecting with state haiar programs
  • Webinar Healthcare-Associated Infections ID Featured Infection, Prevention, and Control

Webinar: Connecting with State HAI/AR Programs and Other...

NACCHO is hosting a webinar to discuss the connection between State DOH HAI/AR...

Jun 05, 2024 | Candice Young, Irene Halferty

Webinar: Connecting with State HAI/AR Programs and Other...

Ao U Photo MEA Corpus Christi7 1
  • All of Us Community Engagement Community Health Informatics

The All of Us Research Program Journey

Learn more about the All of Us Research Program and how you or your...

Jun 03, 2024 | Gelilawit Tamrat, Irene Halferty

The All of Us Research Program Journey

Website New Episode w Special Guests
  • Press Release Community Health Harm Reduction Maternal, Child, & Adolescent Health

NACCHO’s Podcast From Washington: Update on H5N1 and...

Update on H5N1 and Local Health Department Pilot Program Addresses Substance...

May 17, 2024

NACCHO’s Podcast From Washington: Update on H5N1 and...

Build HAIAR Build Topics Webinar
  • Webinar Antimicrobial Resistance Healthcare-Associated Infections ID Featured

Webinar: Reviewing Hot Topics Related to HAIs, AR, and...

NACCHO hosted their May BUILD HAIAR webinar on hot topics related to HAIs and...

May 09, 2024 | Kristen Ross, Irene Halferty

Webinar: Reviewing Hot Topics Related to HAIs, AR, and...

FOC Screenshot
  • Press Release Research & Reports

New NACCHO Forces of Change Study Shows Rising Trends in...

NACCHO released its 2023 Forces of Change Survey.

Apr 30, 2024

New NACCHO Forces of Change Study Shows Rising Trends in...

Website New Episode w Special Guests
  • Press Release Podcast

NACCHO’s Podcast From Washington: New Changes to the WIC...

On this week’s episode: New Changes to WIC Program and Local Health Officer...

Apr 19, 2024

NACCHO’s Podcast From Washington: New Changes to the WIC...

  • Tools & Resources Communications & Public Relations Public Health and Homelessness

NACCHO Social Media Strategy - National Public Health...

National Public Health Week (NPHW) was from April 1 to April 7, 2024.

Apr 11, 2024 | Emma James

NACCHO Social Media Strategy - National Public Health...

Back to Top