Annie Fedorowicz, Adolescent and Adult Immunization Coordinator,
Minnesota Department of Health
Despite the many health benefits recommended vaccines provide, adult immunization rates in the United States are much lower than they should be and lag far behind Healthy People 2020 goals. This troubling trend is exacerbated when it comes to at-risk populations – including seniors, communities of color, limited English proficient persons, and people with chronic illness.
Annie Fedorowicz, the Adolescent and Adult Immunization Coordinator for the Minnesota Department of Health (MDH), is trying to change that by getting to the root causes of vaccine disparities in her state. As Fedorowicz explains, programming can’t be targeted without knowing the underlying issues. MDH has undertaken creative solutions and partnerships to better understand what coverage looks like across different socio-demographic characteristics in Minnesota. One example is how they used data from Minnesota Immunization Information Connection (MIIC), a confidential, population-based, computerized immunization information system (IIS), that centralizes all immunization doses administered by participating health care providers into a patient record for state residents.
The state’s IIS and Vital Records birth certificate data were utilized to examine maternal vaccination coverage and assess potential disparities. Vital records data containing maternal demographic characteristics, prenatal care data, and delivery payment methods were matched to the IIS to determine Tdap and influenza vaccination coverage differences based on race, country of birth, and other demographics. Analysis of the data showed that pregnant woman who received inadequate or intermediate prenatal care were disproportionately in communities of color, with lower levels of education or uninsured. Because Minnesota has several unique immigrant populations, including a large Somali population, this group was analyzed separately. Previous analyses using MIIC and Vitals data have shown pediatric MMR vaccination dropping in our Somali community so we were not surprised when we saw significantly lower coverage for Somali moms. Identifying disparities was a start, but vaccinating these communities where disparities exist remains a challenge. MDH turns to collaborative partnerships on the local level to reach unvaccinated adults. For example, the department has supported and offered technical assistance to the Minnesota Immunization Networking Initiative (MINI), a multi-sector, multi-cultural community collaboration that hosts immunization events in nontraditional community sites such as neighborhood centers and houses of worship. Community volunteers that understand the community best help with translation and fostered trust with the vaccinating nurses that run the program. Fedorowicz recalled one event where an imam was vaccinated as part of the service, with free vaccinations offered to members of the community afterwards.
These successes stem from the creative and research-based solutions MDH has pursued to identify target areas, increase immunization, and most importantly, create open lines of communication between communities and the health department. “It’s an amazing model, and we’re now collaborating with these same partners around pandemic preparedness planning,” says Fedorowicz. “Immunizations are a priority in Minnesota and we’re very focused on creative ways to increase access.”