Strengthening Immunization Program Communications and Outreach Capacity Project Summary
Jul 28, 2025 | Clarissa Montes, Amy Maxson
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Local health departments (LHDs) remain on the forefront of addressing vaccine hesitancy and misinformation. However, many LHDs still face significant gaps in their communications efforts and infrastructure. According to NACCHO’s 2023 Immunization Profile Study, only 16% of LHDs rated their ability to test tailored immunization messaging as “very good” or “excellent,” and almost half (44%) rated their ability as “poor” or “fair.” Additionally, 82% of LHDs reported that vaccine hesitancy was a top challenge among patients and parents.
To help address this gap, NACCHO launched the Strengthening Immunization Program Communications and Outreach Capacity project with funding support from the Centers for Disease Control and Prevention (CDC). This initiative provided funding to ten local health departments across eight states to improve their vaccine communication materials through evaluation strategies, message testing, and community engagement. While each LHD selected which vaccine(s) they would focus on, the shared goal was to develop more culturally appropriate, relevant, and effective immunization messaging, that was informed by their communities of focus. Their experiences offer valuable insights for other LHDs seeking to strengthen their own immunization capacity and communication outreach strategies.
Lessons Learned
Evaluation: Each participating LHD reviewed their existing vaccine communication materials with a target audience in mind. Most employed focus groups, surveys, or interviews to gather insights directly from the community on what could be improved. Even small feedback loops led to improved, more effective vaccine messaging that resonated with their target population(s).
Tailoring Messaging: Participating LHDs emphasized the importance of designing culturally and linguistically relevant materials based on the needs of their target population(s). Several collaborated with trusted messengers, community-based organizations, and residents to ensure that messages reflected community needs.
Partnerships: Several LHDs strengthened existing relationships with partners or formed new ones with community organizations and stakeholders. These partnerships helped increase community reach, facilitated co-creation of materials, and brought new perspectives.
Local Health Department Spotlights
Stories of how participating LHDs utilized evaluation strategies to improve their vaccine communication efforts:
Andrews County Health Department, TX – Hosted a Back to School Bash to boost vaccine access and awareness with support from medical student volunteers. Families received free vaccines, health resources, and school supplies. The event increased trust and vaccine acceptance and will now be held annually to reach more families.
Cameron County Public Health, TX - Launched a community-informed HPV education campaign to address low vaccination rates and cultural stigma. Educational materials were created bilingually and focused more on cancer prevention.
County of Santa Clara Public Health Department, CA – Partnered with trusted groups to improve vaccine messaging for Latino agricultural workers. Community input led to clearer, culturally relevant materials, showcasing the value of co-creating messages.
Genesee County Health Department, MI – Developed an HPV Vaccination Improvement Toolkit a customizable resource for LHDs to boost HPV vaccination rates.
Martin County Health Department, KY – Use of open dialogue helped parents feel informed and confident in vaccinating their children.
Multnomah County, OR - Held listening sessions with Black and African community members to evaluate vaccine materials. Feedback emphasized the need for trust, autonomy, and transparency in messaging.
Portland Public Health Division, ME – Collaborated with community leaders and held focus groups to create culturally tailored vaccine materials and redesign outreach materials to address hesitancy and improve accessibility.
Public Health – Dayton and Montgomery County, OH – Launched survey to understand declining childhood vaccination rates. Findings indicated vaccine misinformation and access barriers as key issues. After testing messages with parents, a back-to-school campaign was chosen to encourage routine vaccinations.
Trumbull County Combined Health District, OH – Community feedback showed a need for extended clinic hours and updated communication materials.
Umatilla County Health Department, OR – Developed a podcast to highlight local public health initiatives.
Looking Ahead
This project demonstrates that LHDs can enhance vaccine communications by engaging communities and evaluating messages. As the immunization landscape continues to evolve, NACCHO remains committed to supporting LHDs with tools and strategies to build vaccine confidence and improve vaccination rates.
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