Journal of Public Health Management and Practice
2019

Vaccination Capability Inventory of Community, Migrant, and Homeless Health Centers: A Survey Report (Article)

Lewis J.H.* , Whelihan K. , Roy D. , White E.J. , Morgan C. , Vora R.S. , Boyle K.R. , Luebbering C. , Curtis Bay R. , Lindley M.C.
  • a Departments of Public Health, School of Osteopathic Medicine in Arizona, A. T. Still University of Health Sciences, 5850 E Still Cir, Mesa, AZ 85206, United States
  • b Departments of Public Health, School of Osteopathic Medicine in Arizona, A. T. Still University of Health Sciences, 5850 E Still Cir, Mesa, AZ 85206, United States
  • c A. T. Still Research Institute, Department of Interdisciplinary Health Sciences, A. T. Still University of Health Sciences, Mesa, AZ, United States
  • d Undergraduate Medical Education, Department of Interdisciplinary Health Sciences, A. T. Still University of Health Sciences, Mesa, AZ, United States
  • e Graduate Medical Education, Department of Interdisciplinary Health Sciences, A. T. Still University of Health Sciences, Mesa, AZ, United States
  • f School of Osteopathic Medicine in Arizona, Department of Interdisciplinary Health Sciences, A. T. Still University of Health Sciences, Mesa, AZ, United States
  • g KRB Clinical Solutions LLC, Montville, NJ, United States
  • h Department of Research Support, A.T. Still University of Health Sciences, Kirksville, MO, United States
  • i Arizona School of Health Sciences, A. T. Still University of Health Sciences, Mesa, AZ, United States
  • j Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States

Abstract

Context: Federally funded Community, Migrant, and Homeless Health Centers provide health services to the most vulnerable communities in the United States. However, little is known about their capabilities and processes for providing vaccinations to adults. Program: We conducted the first national survey of health centers assessing their inventory, workflow, capacity for, and barriers to provision of routinely recommended adult vaccines. In addition, we asked health center leaders' perceptions regarding best practices and policy recommendations for adult vaccinations. Implementation: A survey was developed on the basis of domains elicited from advisory panels and focus groups and was sent electronically to leaders of 762 health centers throughout the United States and its territories; data were collected and analyzed in 2018. Evaluation: A total of 319 survey responses (42%) were obtained. Health centers reported stocking most routinely recommended vaccines for adults; zoster vaccines were not stocked regularly due to supply and storage issues. Respondents most commonly reported adequate reimbursement for vaccination services from private insurance and Medicaid. Most vaccinations were provided during primary care encounters; less than half of health centers reported providing vaccines during specialist visits. Vaccines administered at the health center were most commonly documented in an open field of the electronic health record (96%) or in an immunization information system (72%). Recommendations for best practices related to better documentation of vaccinations and communication with immunization information systems were provided. Discussion: Health centers provide most adult vaccines to their patients despite financial and technological barriers to optimal provisioning. Further studies at point of care could help identify mechanisms for system improvements. © 2019 Wolters Kluwer Health, Inc.

Author Keywords

adult vaccines immunization information systems Health centers

Index Keywords

[No Keywords available]
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85072937644&doi=10.1097%2fPHH.0000000000001073&partnerID=40&md5=152c99c3075047c150cd5dca544cb8f6
DOI: 10.1097/PHH.0000000000001073
ISSN: 10784659
Original Language: English