Minnesota is home to a culturally and socioeconomically diverse population and the state’s local public health departments serve as a critical safety net in provider of vaccinations for uninsured or underinsured individuals. However, it can be difficult to connect with the community members who need our services most. By attending the 2018 National Immunization Conference, we were able to learn strategies for improving our jurisdiction’s immunization rates.

The Federal Government and State of Minnesota provide funding and vaccines through the Vaccines for Children and Uninsured and Under-insured Adult Vaccine Programs, enabling local health departments to administer vaccinations to eligible individuals. For many families, cost can be a barrier to vaccination but these programs help remove that obstacle. We do our best to promote such programs and our immunization services, but uninsured families and individuals are a challenge to identify and reach. To overcome these challenges, Anoka County Community Health ensures that immunization materials are freely available to all clinics, community partners, and stakeholders for distribution.

We develop posters and flyers in seven languages; hang them at all county and government buildings and school health offices; and post electronic versions on our county website and on the county building monitors located by all entryways and elevators. With these resources, we promote our counties’ immunization clinics at local Women, Infants, and Children (WIC) offices, Economic Assistance offices, food shelves, and through Family Health and Child & Teen Checkups Programs throughout the county. We also use social media to send messages promoting the importance of immunizations for all ages and attend community resource fairs, the county fair, and back-to-school events. However, last year’s unprecedented measles outbreak was a reminder that we need to diversify our outreach strategies even further.

In 2017, Anoka County Community Health participated in the National Association of County and City Health Officials (NACCHO) Assessment of Local Health Department Immunization Programs. By participating in the assessment, I was given the opportunity to enter my name into a random drawing to receive scholarship funding from NACCHO to attend the 48th National Immunization Conference (NIC). As the lucky scholarship recipient, I was able to attend NIC sessions and speak to both presenters and attendees who, like myself, face a multitude of challenges reaching out and meeting the needs of the diverse populations that make up their county and community. Several NIC presentations explored strategies for enhancing immunization outreach and education and increasing vaccination rates, including:

• Strategies to Improve Childhood and Adolescent Immunization Coverage
• HPV Messaging for Parents and Healthcare Professionals
• Local Public Health Department Strategies for Increasing HPV Rates
• Vaccination Coverage among Unaccompanied Children
• Help Improve Adult Immunization Rates

The information presented in these sessions was informative to my own education and enabled me to walk away with new approaches to put into practice. For example, using a variety of communication methods, including mailing reminder/recall cards monthly, has resulted in improved vaccination rates for our clinics.

Further, the conference connected me with other immunization champions from state and county agencies, as well as those focused on Indian Health Services. In our conversations, we traded tools and best practices for meeting the needs of the diverse people seen at local vaccine clinics. I talked about how we use our state immunization information systems for vaccine reminder/recall and translated materials to advertise and promote public immunization clinics, tactics that were common across conference participants. In return, I heard about QI Projects and large cohort studies, which provided new perspectives on problems like vaccine hesitancy and helped me develop new strategies that I and my immunization staff can use when promoting and talking about the benefits of vaccines.

As the make-up of our population changes and families face tough issues, including unemployment and job downsizing, housing instability, costly health insurance, lack of public safety nets and unstable support networks, providing an opportunity for free or low-cost vaccines to all eligible children, teens, and adults is vital to ensure a healthy, diverse, and growing community. By combining our existing outreach strategies with those learned at NIC, we are seeing increased traffic and a diverse age group and spectrum of populations at our immunization clinics. And most importantly, we are ensuring that all our community members, especially those most vulnerable to acquiring vaccine preventable illnesses, are able to receive safe and appropriate immunizations.

One challenge that we’re looking to overcome is that our state’s local public health clinics have limited use of social media, which means we’re missing out on opportunities to broadcast messaging to large groups of people, especially hard-to-reach populations such people experiencing homelessness, people with limited English proficiency, and teenagers. A long-range goal for Anoka County Community Health could be to develop policies around the use of county Facebook or Twitter channels to communicate effective messages to such groups.

Ultimately, my experience at NIC broadened my lens beyond local public health and allowed me to see state and national perspectives. I also came away from the conference realizing that our county has already implemented many strategies discussed at the conference. This makes me proud and confident in our immunization practices.