National Immunization Awareness Month in August is an opportunity to focus on back-to-school immunizations and prepare for the upcoming respiratory disease vaccine season.
Declining Immunization Coverage
CDC data show that kindergartner vaccination coverage has steadily declined for all vaccines over the past two school years, from 95% to 93% nationally and by as much as 10% in some jurisdictions, bringing vaccination rates to the lowest levels we’ve seen in the last decade.
IHS data show similar declining patterns for two-year-olds. While the decreasing trend started before the pandemic, current rates are about 25% lower than in 2016. This is data from a manual entry, voluntary data system, which makes it difficult to get a clear picture of how coverage has shifted within IHS.
The 2023-2024 Respiratory Disease Vaccine Season: Navigating New Terrain
In years past, we have typically called the fall and winter months “flu vaccine season.” Starting this year, we will refer to this time of the year as “respiratory disease vaccine season.” This change is to acknowledge that we have multiple vaccines that must be promoted and administered this time of year, with the addition of COVID-19 vaccines for everyone 6 months and older and RSV preventive drugs for infants up to 19 months of age, as well as RSV vaccines for pregnant women and some older adults.
These new vaccines provide a challenging and exciting opportunity to improve the well-being of people served at IHS clinic sites. We look forward to sharing resources and support as we navigate this new vaccine landscape together. In the meantime, we encourage you to share information about the latest vaccine recommendations with existing resources, including for RSV , COVID-19 , and influenza .
The IHS National E3 Vaccine Strategy
In November 2022, IHS Chief Medical Officer Dr. Loretta Christensen announced the IHS National E3 Vaccine Strategy to address declining vaccine coverage rates in Indian Country. As a clinical and public health prevention priority, IHS will offer Every patient at Every encounter Every recommended vaccine, when appropriate. This includes all vaccines recommended by the CDC Advisory Committee on Immunization Practices for infants, children, adolescents, and adults.
We are in this Together!
All staff in health care practices, including non-clinical staff, play essential roles during the immunization process. Here are some ways clinics can prepare for back-to-school and respiratory disease season:
- Raise awareness about declines in kindergarten vaccination coverage and the need to get all school vaccination coverage back on track.
- Engage staff in learning opportunities with CDC’s Immunization Education and Training courses via lunch and learns or watch #HowIRecommend videos.
- Make clinics a supportive space that welcome vaccine questions and concerns from patients and parents. Practice responses to frequently asked questions.
- Use proven strategies to encourage parents and patients to stay up to date on vaccinations.
- Make up-to-date immunization schedules easy for parents and patients to find by displaying them on websites and posting them in waiting rooms. Use tools like PneumoRecs VaxAdvisor Mobile App to help make vaccine recommendations.
While new vaccines and diseases require constant learning and innovative techniques to achieve high coverage rates, we have heard many stories of camaraderie, community engagement, and novel strategies that are already leading to a bounce-back in routine immunization rates at many IHS sites. If we continue to share lessons learned and come together across geographies and disciplines, this year’s respiratory season will be a success!
Lastly, I want to acknowledge the unprecedented levels of health worker burnout and mental health distress we saw during the COVID-19 pandemic. If these issues are not addressed, health workers will continue to suffer, and patients will not get the care they need . I hope that by speaking openly about burnout, taking every opportunity to celebrate and thank our health workers, and providing resources for self-care, we will reduce stigma, make mitigation a part of routine immunization program planning, and thereby create space to allow health workers to heal and thrive.
Additional resources on health care worker burnout:
