1. Chicago Department of Public Health
National Immunization Conference May 11, 2004
CHICAGO READII
Julie Morita, M.D.
Medical Director
Immunization Program
Chicago Department of Public Health

2. Overview Background Chicago READII Goals Highlights
Aldermanic offices role in improving access to vaccines
Free vaccine as an incentive for providers to join READII Quality Improvement Initiative

3. Chicago Population Total  65 years NH White 31% 50%
NH African American
36%
Hispanic
26% 9%

4. Chicago Neighborhoods76 51 25 28 55 61 70 49 30 24 10 56 15 19 71 17 53 23 54 22 69 66 02 46 09 01 12 13 77 11 04 14 03 16 05 06 21 18 20 07 08 26 27 32 29 33 31 34 60 35 59 36 58 38 57 37 39 62 63 40 41 64 68 42 67 65
READII Neighborhoods 43 45
African-American 44 48 47
Hispanic 73 72 50 52 74 75

5. Immunization Coverage Among Persons > 65 yrs, Chicago
Medicare Beneficiary Survey, February-April, 2003

6. Chicago READII Goals
Improve access to immunizations in READII neighborhoods
Aldermanic offices
Increase providers’ use of effective immunization strategies
Vaccine as an incentive
Increase minority seniors’ knowledge about influenza and pneumococcal diseases and immunizations
Community Outreach
Media Campaign

7. Improving Access to Immunizations, 2003
City of Chicago purchased vaccine
Influenza vaccine doses: ,000
Pneumococcal vaccine doses: 5,000
City-wide distribution:
Mass immunization clinics:
Private and public clinics:

8. Vaccine Administered in READII Neighborhoods
Mass Immunization Clinics: 48
Community based organizations, Park Districts, Senior Housing, Aldermanic Offices
Influenza vaccine: 5,480
Pneumococcal vaccine:

9. Aldermen: Chicago’s Legislative Representatives
READII neighborhood Aldermen: 23
Participating Aldermanic offices: 11
Mailings, phone calls, flyer distribution
Hosted mass immunization clinics
Administered doses:
Influenza: 1,431 (29% of total)
> 65 years: (49%)
PPV: (25% of total)
> 65 years: (64%)

10. Lessons Learned, Aldermen
Aldermanic offices have access to their constituents > 65 years
Mailing lists
Phone numbers
Offices that contacted their senior constituents had greater senior participation
Aldermanic offices may be effective partners in promoting and administering adult immunizations

11. Future Plans, Aldermen
All 23 Aldermanic offices in READII neighborhoods will be encouraged to host and/or publicize clinics
Outreach guidance and staff will be provided by READII project
Mail and phone notifications, flyer distribution, community meeting presentations

12. Increasing Providers’ Use of Effective Immunization Strategies
Quality Improvement (QI) Approach
Illinois Foundation for Quality Health Care
Free assessments of office-level immunization coverage
Free, ongoing in-office education
Standing orders, staff and/or patient reminders, or patient recalls
Few providers/clinics interested
Lack of access to free adult vaccine identified as primary barrier to immunization

13. A Novel Incentive: Free Vaccine
Recruitment letters
Sent to all providers in READII neighborhoods
Described QI activities
Offered influenza and pneumococcal vaccines as incentive for participation
Phone calls
Targeted adult providers in READII neighborhoods

14. Provider Participation
Participating clinics: 28
Private clinics: 14
Federally Qualified Health Centers: 14
Clinics receiving CDPH vaccine: 26/28
Most clinics purchased additional vaccine
Four clinics received all vaccine from city-purchased vaccine

15. Vaccine Distribution, Clinics in QI Project
Influenza vaccine
FQHCs: ,910
Private clinics: ,200
No-purchase clinics:
Pneumococcal vaccine
FQHCs: ,050
Private clinics: ,655
No-purchase clinics:

16. Lessons Learned, Free Vaccine
Public and private providers perceive the lack of free adult vaccine as a barrier to administration of immunizations
Provision of influenza and pneumococcal vaccines was a useful incentive for participation in Chicago’s QI effort
Provision of free vaccine may eliminate a barrier to administration of adult immunizations

17. Future Plans, Free Vaccine
Provide free vaccine to clinics in READII neighborhoods
Evaluate the impact of free vaccine on immunization coverage
Follow-up assessments of office-level immunization coverage
Provider survey
Strategies implemented
Vaccine purchases

18. Remaining Challenges
Different partners and approaches are required for different minority groups
Engaging culturally-specific partners to improve access to vaccine
Revising immunization messages to be culturally-specific
Identifying trusted persons to deliver immunization messages

19. Acknowledgements African American Health Care Council
Chicago Hispanic Health Coalition
American Lung Association of Metropolitan Chicago
White Crane Wellness Center
Cook County Bureau of Health Services
Illinois Foundation for Quality Health Care
Centers for Medicare and Medicaid Services Region V Office
Chicago Department on Aging
Chicago Housing Authority