Public Provider Immunization Assessments in Indiana
2000 Assessment Results
The results from the 2000 Indiana public provider immunization assessments demonstrate that many public providers throughout the state have made improvements in their immunization practices during the past year. For example, among local health departments median coverage levels for each individual vaccine, are higher than 90%, except for DTaP. The different vaccine-series have median coverage levels near 80% or greater, highlighting the fact that more than half of the 94 local health departments have achieved or came close to achieving the Healthy People 2000 goal of 90% coverage among two-year olds by the year 2000. Improvements were also found among non-health department public providers.
Declining drop-out rates for the DTaP and hepatitis B vaccine series also highlight further improvements made by public providers. In 1999 the drop-out rate for DTaP was 11.3% for local health departments and 18.7% for non-health department public providers. This year's assessment results showed a decrease in this rate to 9.6% and 16.7%, for these providers, respectively. Continued use of reminder and recall systems can help bring a further decline in the drop-out rates for these vaccine series.
According to the 2000 Epidemiology and Prevention of Vaccine-Preventable Diseases (1), "routine assessment and feedback of vaccination rates obtained at the provider site - whether public or private - is one of the most effective strategies for achieving high, sustainable vaccine coverage." The immunization assessment provides the information each individual provider needs to: a) better understand their own immunization practices and coverage levels, and b) decide which type of interventions are necessary to improve those practices and coverage levels. Receiving an immunization assessment and the subsequent feedback is only the first step towards improving immunization practices. Acting on those findings, which are specific to each provider, will ultimately lead to improved practices and higher coverage levels among a provider's patients.
With the anticipation of licensure of new vaccines and the new recommendations that will accompany them, the immunization schedule will only become more complex in coming years. Among the many challenges these developments bring is the inevitable difficulty health care providers will face to ensure high immunization coverage levels of their patients. Through continued use of assessment and feedback methods, providers will be able to closely track their own immunization practices. By implementing specific programmatic interventions, as indicated by assessment findings, we will continue to see improvements in immunization coverage levels and a further reduction in the incidence of vaccine-preventable disease throughout Indiana.