State Immunization Services and Policies Resource Page
Updated June 2021/by Rebecca Cooper
Vaccines are a powerful and cost-effective tool to prevent diseases and save lives. According to estimates, vaccines will prevent 40,000 deaths and 20 million illnesses among 4.3 million US infants born in 2009 over their lifetimes and also save $10.20 for every $1 invested. While the Vaccine for Children and Medicaid programs have reduced racial and ethnic disparities, they persist, especially among adults. These resources showcase effective state strategies to harness Medicaid’s reach to increase immunization rates, reduce disparities, and achieve equity in immunizations. To suggest a resource or share your state’s immunization efforts, email Rebecca Cooper.
Immunizations and COVID-19
Two States’ Approaches to Leveraging Data for Equitable COVID-19 Vaccine Distribution, May 2021. Minnesota and North Carolina took different approaches to developing COVID-19 immunization data systems. State officials from each state discuss their experiences including data challenges, successes, and implications for ensuring an equitable vaccine roll out now and in the future.
States Adapt COVID-19 Vaccination Strategies for Adolescents Ages 12-15, May 2021. The approval of the COVID-19 vaccine for anyone 12 and older raises new considerations, including consent and vaccine hesitancy among parents and youth. States are building on existing distribution strategies to vaccinate adolescents, including distributing the vaccine through pediatricians’ offices, at schools, and during sporting events, and allowing parental consent over the phone.
States Address Racial and Ethnic Disparities in their COVID-19 Responses and Beyond, March 2021. As communities of color have been disproportionately affected by COVID-19, states are working to prioritize equity in their response and recovery efforts. This blog features the equitable approaches states are using to address the effects of the COVID-19 pandemic today and in the future.
State Strategies for Vaccinating Individuals Experiencing Homelessness against COVID-19, March 2021. In addition to the COVID-19 vaccine distribution challenges states face – such as limited supplies, getting second doses administered, and vaccine hesitancy – immunizing individuals experiencing homelessness has its own difficulties. States are developing strategies, including partnering with nonprofits that work with this population, setting up mobile vaccine clinics, and connecting the Homeless Management Information System to state immunization registries and electronic health records to track doses, to reach these individuals.
Johnson & Johnson COVID-19 Vaccine Helps States Boost Supply, But Messaging Remains Critical, March 2021. The recent approval of the one-dose Johnson & Johnson (J&J) vaccine, which is easier to store and transport and reported to cause fewer side effects, helps states improve their vaccination outreach. However, these efforts have been complicated by mixed messaging around its efficacy. States, with federal guidance, are emphasizing the benefits of the J&J vaccine and the importance of getting vaccinated as soon as possible with whatever vaccine is available.
States Identify and Address COVID-19 Vaccine Disparities through Targeted Rollout and Outreach, February 2021. As states rapidly work to get COVID-19 vaccines into arms as quickly as possible as viral variants spread across the country, officials know vaccine rollout plans must focus on equitable distribution, especially in Black and Latinx communities that have experienced disproportionately high infection rates, hospitalizations, and deaths. This NASHP report highlights state strategies for collecting, analyzing, and using race and ethnicity data to increase equity and reduce disparities in vaccine distribution.
States Quickly Retool Strategies to Maximize Vaccination Coverage, January 2021. Faced with limited vaccine supplies, a slow rollout of federal funds, and new federal guidelines allowing vaccination of those 65 and older, states face distribution challenges as they quickly evaluate which mass immunization practices are most effective.
State Plans for Vaccinating their Populations against COVID-19, January 2021. Guided by evolving federal recommendations and limited vaccine supplies, states are continually refining their distribution plans that prioritize when specific workforce members and populations receive the COVID-19 vaccine. The chart below shows how each state is prioritizing populations in its distribution plans. The chart’s Overview tab shows when states last updated their plans, which phase they are currently in, and links to the information on states’ websites.
With Federal Guidance Evolving and Vaccine Supplies Uncertain, States’ COVID-19 Vaccine Distribution Plans Remain Works in Progress, December 2020. The timely and equitable distribution of COVID-19 vaccines falls squarely on states that are already stretched thin by the pandemic and face evolving federal guidance. With the first COVID-19 vaccine expected to be approved later this week, this blog explores the challenges states face in storing and distributing the vaccine, and this chart highlights states’ initial approaches to prioritizing which of their workforce members or populations will get the vaccine first.
States Race to Create COVID-19 Vaccination Distribution Plans, October 2020. As COVID-19 vaccine development continues, states are racing to develop distribution plans. NASHP recently convened state officials who discussed preparations for vaccine storage and administration, data tracking, and capacity issues. They noted that while guidance is emerging, there is currently no unified federal plan detailing who will pay for its deployment, how it will be equitably distributed, and effective vaccine messaging. This blog explores what questions remain.
States Factor in COVID-19’s Impact on Immunizations and VBP Incentives, June 2020. In recent years, a number of state Medicaid programs have instituted value-based payment (VBP) programs to reward managed care organizations for quality care, including achieving high child immunization rates. However, COVID-19 has reduced in-person visits and immunization rates, and this blog examines federal and state guidance and flexibility in VBP incentive calculations to accommodate these declines.
States Establish New Telehealth Policies to Safeguard Well-Child Care and Immunizations, May 2020. COVID-19 has affected children’s access to preventive care across the country; while states’ expanded telehealth policies can increase access to care, in-person visits are still needed for delivery of immunizations and other critical screenings. This blog highlights new state policies on telehealth and well-child visits to ensure children stay healthy during this pandemic and beyond.
State Strategies to Improve Immunizations
State Levers to Improve Immunization Rates: Alabama’s Experience, February 2020. Alabama employs a multifaceted approach to boost immunization rates among its Medicaid, public, and privately covered populations. This NASHP blog details the state’s strategies, including various payment and reimbursement incentives, reporting protocols, and cross-agency partnerships.
State Medicaid Levers to Promote Immunization: California’s Experience, September 2019. This NASHP blog highlights strategies California is using to increase childhood immunization rates among Medicaid enrollees, including incentivizing providers, using the state immunization registry to monitor vaccination uptake and requiring managed care organizations to monitor and report on quality measures.
Using Data and Innovation, States Work to Improve Maternal Vaccination Rates, November 2019. This NASHP blog examines different strategies California, Colorado, and Wisconsin are using to improve maternal vaccination rates, ranging from including requirements and incentives in Medicaid managed care contracts to using data to identify populations, regions, and providers with low immunization rates.
Hawaii Fights the Flu with Pop-up Clinics and State Agency Collaboration, February 2019. This NASHP blog highlights Hawaii’s collaboration between its state education and health departments, which led to “pop-up,” school-based vaccination clinics to increase flu vaccination rates and protect children’s health.
Improving Medicaid Immunization Rates through State Partnerships
To address immunization gaps among low-income pregnant women, and children, the National Academy for State Health Policy (NASHP), AcademyHealth, and Immunize Colorado coordinated efforts through a three-year US Centers for Disease Prevention and Control cooperative agreement to support states in implementing immunization improvement strategies and policies. The project team convened a community of practice, staff from Medicaid agencies, immunization programs, and immunization information systems in five states.
NASHP and AcademyHealth Launch New Community of Practice to Boost Immunizations. January 2021. As states work to distribute COVID-19 vaccines, six states now have the opportunity to highlight the importance of immunizations through a new community of practice (CoP). NASHP and AcademyHealth, with support from Immunize Colorado, are facilitating a new CoP with Louisiana, Michigan, Texas, Washington, Wisconsin, and Wyoming to improve Medicaid policies and outreach to increase immunization rates among low-income children and pregnant women.
Announcement of a New Community of Practice to Improve Immunization Rates, November 2020. NASHP and AcademyHealth announce ….
Announcement of a New Community of Practice to Improve Immunization Rates, November 2020. NASHP and AcademyHealth announce a new community of practice focused on immunizations. Funded by a Centers for Disease Control and Prevention cooperative agreement, Eliminating Barriers to Immunization Through Collaborative Use of State Agency Resources, AcademyHealth and NASHP seeks five to seven states, whose multidisciplinary teams will include a Medicaid medical or policy director, immunization state program manager, and state immunization information system coordinator, to form a community of practice. Each state’s team will identify barriers to and share practices for increasing immunization rates. Learn more.
Results of a Five-State Community of Practice to Improve Medicaid Immunization Rates through Partnerships, October 2020. NASHP coordinated a CDC funded five-state community of practice to facilitate states’ work in interdisciplinary cross-agency teams to address access and other challenges to reduce immunization gaps among low-income pregnant women and children. This blog highlights approaches and lessons learned that can help states address disparities and improve access to vaccines.
State Snapshots Identify Immunization Successes, September 2020. NASHP and AcademyHealth’s CDC-funded community of practice created these state snapshots to provide an overview of this five-state project and successes the five states achieved to increase immunization rates among Medicaid-enrolled pregnant women and children.
How to Boost Vaccine Rates for Low-Income Families, October 2018. This PEW Charitable Trusts article explores a Community of Practice Immunization project, co-led by the National Academy for State Health Policy, AcademyHealth, and the Colorado Children’s Immunization Project.
State Officials Work to Harness Medicaid as a Change Agent to Increase Immunization Rates, July 2018. This reports on a meeting led by NASHP, AcademyHealth, and the Colorado Children’s Immunization Coalition, which convened state officials and experts to identify strategies to improve immunization rates among Medicaid-enrolled children and pregnant women.
Immunization Community of Practice, February 2018. AcademyHealth and NASHP, with support from the Immunize Colorado, worked with state officials interested in improving their immunization rates among low-income children and pregnant women in a Community of Practice. Medicaid agencies worked with public health and Immunization Information System partners to improve policies and outreach to increase immunization rates.
New Program Helps State Medicaid Programs Close an Immunization Disparity Gap, February 2018. This NASHP blog explores how states can improve immunization rates among low-income children by addressing health equity.
State Immunization Strategies to Promote Children’s Preventive Services, last updated September 2016. These maps and 50-state chart illustrate state Medicaid or Children’s Health Insurance Program performance-improvement initiatives that promote children’s preventive services, including immunizations and American Academy of Pediatrics’ Bright Futures recommendations.
Centers for Disease Control and Prevention Resources
Vaccination Coverage Among Children Aged 19–35 Months — United States, 2017, October 2018. This Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Review (MMWR) article highlights current vaccination coverage data and trends.
Vaccine-Preventable Diseases, Immunizations, and MMWR –1961 – 2011, October 2011. This CDC report discusses the history of vaccine-preventable diseases, current global efforts, and the future of immunizations.