Two Multicomponent Intervention Recommendations to Increase Appropriate Vaccinations

Learn what the Community Preventive Services Task Force (Task Force) says about increasing vaccination rates. The Task Force’s latest evidence-based recommendations and findings highlight several settings and approaches to consider for implementation of programs, services, and policies to increase vaccination rates.

The Task Force issued the following recommendations for increasing appropriate vaccination:

• Health Care System-Based Interventions Implemented in Combination
• Community-Based Interventions Implemented in Combination

The links above provide full Task Force recommendations, findings and rationale statements, information about the systematic reviews on which they are based, and more.

Task Force recommendations and findings are based on systematic reviews of the literature conducted by scientists and subject matter experts from the Centers for Disease Control and Prevention (CDC). The reviews were carried out with Task Force oversight, in collaboration with a wide range of government, academic, policy, and practice-based partners.

What is meant by health care system-based interventions implemented in combination?

Health care system-based interventions implemented in combination involve the use of two or more coordinated interventions to increase vaccination rates within a targeted client population. Interventions are implemented primarily in health care settings, although efforts may include additional activities within the community.

The Task Force recommends further recommends a combination that includes the following:

• At least one intervention to increase client demand for vaccinations
• And one or more interventions that address either, or both, of the following strategies:
  • Interventions to enhance access to vaccination
  • Interventions directed at vaccination providers

What is meant by community-based interventions implemented in combination?

Community-based interventions implemented in combination involve the use of two or more coordinated interventions to increase vaccination rates within a targeted population.

Efforts involve partnerships between community organizations, local government, and vaccination providers to implement and coordinate one or more interventions to increase community demand and one or more interventions to enhance access to vaccination services.

They may also include additional interventions directed at vaccination providers.

Why are the Task Force recommendations important?

• Immunizations are among the top ten great public health achievements of the 20th century for their success in realizing substantial declines in cases, hospitalizations, deaths, and health care costs associated with vaccine-preventable diseases. (CDC 2011; CDC 1999).
• Approximately 20 million disease episodes and 42,000 premature deaths are prevented by recommended childhood vaccinations that protect against the following: diphtheria, tetanus, pertussis, Haemophilus influenza type b (Hib), poliovirus, measles, mumps, rubella, hepatitis B, varicella, hepatitis A, pneumococcal conjugate and rotavirus; this results in estimated net savings of $68.8 billion (2009$) from averted medical costs and reduced absenteeism from work (Zhou et al., 2014).
• Sustaining current vaccination rates and increasing rates for those vaccines below national target levels are needed to maintain the low incidence of vaccine-preventable diseases and to prevent a resurgence of infectious diseases in the U.S. (CDC 2013).
• Well-coordinated activities that foster high immunization rates depend on the availability of timely, accurate, and complete information pertaining to vaccinations received by members of a population (Yusuf et al., 2002).

What are the Task Force and Community Guide?

• The Community Preventive Services Task Force (Task Force) is an independent, nonfederal, unpaid panel of public health and prevention experts. The Task Force works to improve the health of all Americans by providing evidence-based recommendations about community preventive programs, services, and policies to improve health. Its members represent a broad range of research, practice, and policy expertise in community prevention services, public health, health promotion, and disease prevention.
• The Guide to Community Preventive Services (The Community Guide) is an essential resource for people who want to know what works in public health. It provides evidence-based findings about public health interventions and policies to improve health and promote safety.
• The Centers for Disease Control and Prevention (CDC) is mandated by the U.S. Congress to provide ongoing administrative, research, and technical support for the operations of the Task Force. CDC is therefore committed to working with the Task Force to systematically review the scientific evidence on population-based strategies to reduce the burden of preventable disease, injury, and disability.

For More Information

• The Community Guide: Vaccination
  • What Works Fact Sheet: Increasing Appropriate Vaccination [PDF – 430 KB]
• CDC, Vaccines and Immunizations
• Advisory Committee on Immunization Practices (ACIP)

References

Centers for Disease Control and Prevention. National, state, and local area vaccination coverage among children aged 19 35 months United States, 2012. MMWR 2013; 62(36);733-40.

Centers for Disease Control and Prevention. Ten great public health achievements United States, 2001-2010. MMWR 2011; 60(19):619-23.

Centers for Disease Control and Prevention. Ten great public health achievements United States, 1900-1999. MMWR 1999; 48(12):241-3.

Yusuf H, Adams M, Rodewald L, et al. Fragmentation of immunization history among providers and parents of children in selected underserved areas. American Journal of Preventive Medicine 2002;23(2):106-12.

Zhou F, Shefer A, Wenger J, Messonnier ML, Wang LY, Lopez A, Moore M, Murphy TV, Cortese M, Rodewald L. Economic evaluation of the routine childhood immunization program in the United States, 2009. Pediatrics 2014 April; 133(4); 1-11.