Central Oregon Shots For Tots

State: OR Type: Model Practice Year: 2004

In 1998 Deschutes County ranked 35th out of 36 counties when assessing up-to-date immunization criteria for 0-2 year olds. Deschutes County, Oregon has a population of 130,500 people inclusive of urban and rural regions and is the fastest growing county in Oregon. The Deschutes County Immunization Coalition was created to address the immunization issues and develop a plan to increase immunization rates. Barriers to immunizing were identified as lack of local access, no public transportation, and lack of public awareness. Financial constraints and lack of insurance coverage were also viewed as barriers. The coalition identifed children aged birth through 3 years old as their target population and would additionally promote immunizing through age 18. Decisions were made to organize and implement a sustainable mass immunization program. Central Oregon Shots For Tots clinic program was created to increase immunization rates in Deschutes County, Oregon. The Deschutes County Health Department (DCHD) recruited and trained medical volunteers to administer the immunizations and local Rotary clubs recruited volunteers to organize the clinics. Community corporate and business partners provided services, supplies, printing, advertisement and sponsorship to promote the program. The frst series of clinics was held in May 1999. Since that time, clinics have been held three times a year in each of the four communities in the county for a total of twelve clinics per year. To date, over 6500 children have been immunized at these clinics. In 2004 DCHD immunization coverage for 0-2 year olds was 70.6%, placing Deschutes County 11th out of 36 counties. The primary goal is to increase public awareness and provide reliable opportunities to immunize by increasing convenient access, ultimately improving immunization rates of children to meet or exceed the CDC national benchmark for 0-2 year old group of 90% by the year 2010.
Immunization rates for children in Deschutes County have consistently been below benchmark criteria. In 1997 the up-to date immunized rate for 0-2 yr olds was at 58%. Central Oregon Shots For Tots (SFT) was created to provide immunizations to protect children at risk of disease and reduce immunizing barriers for parents. Response in collaborative efforts by coalition members has made this program a success. Clinics are held in four diferent zip codes within the county three times a year. All clinics are held on Saturdays on a walk-in basis helping to alleviate challenges to parent schedules. SFT functions via an exceptional cohort of medical and service volunteers. Deschutes County Health Department (DCHD) trains medical volunteers to administer the immunizations and local Rotary club volunteers are trained on clinic process. Multiple community partners are involved in donations of space, supplies and service. DCHD brings VFC/317 funded vaccine and through eligibility screening is able to offer it at low or no cost. Great satisfaction is a common theme by those that participate or promote the program knowing they are making a difference in the life of a child.
Agency Community RolesSFT has provided a distinctive opportunity to create strong partnerships with community members. It has also elicited county wide support toward maintaining a healthy community. DCHD responsibilities include securing facilities, recruiting medical volunteers and training them in immunization administration, scheduling medical volunteers, and coordinating supplies for each clinic. DCHD takes a lead role in determining immunization needs for each child, screening for contraindications, and counseling parents regarding before, during and after immunization care. Medical volunteers administer the appropriate vaccines guiding the parents in comfort measures and distraction techniques. Local Rotary clubs of each community place advertisement banners, distribute flyers, contribute fiscally, and are an essential presence at each SFT clinic providing direction to the clients and escorting them through the entire process.  Costs and ExpendituresCentral Oregon SFT program was initially funded by a Rotary International grant to assist the Deschutes County Immunization Coalition in improving immunization rates. Following the grant, local Rotary clubs have continued to sponsor the program. Clinics are supervised by at least one registered nurse from DCHD which is a paid staff member, expenditure of approximately $300.00 per clinic. The supervisor is responsible for clinic quality, client screening, procedures, vaccine accountability, documenting and reporting data. Community partners have waived the costs for facility usage and advertisement fees, donated clinic supplies, reduced fees for printing promotional materials, prepared and delivered free food and beverages, and volunteered their time in service.  ImplementationIn the winter of 1998 the Deschutes County Immunization Coalition was formed and met monthly to address the low immunization rates. Immunization research documents were evaluated regarding best practices for increasing vaccination coverage. Decisions were made to address the community in a long term public awareness campaign and create a sustainable mass immunization program. A Rotary representative applied for and was awarded a $25,000 grant to establish a fully-funded program. The cooperation of Rotary, DCHD and community partners was critical to coordinating the program. Oregon law requires that a certified public health nurse supervise the clinics and DCHD agreed to the commitment. In addition, medical volunteers must register as volunteer employees of Deschutes County, clear screening processes, and be trained in vaccine administration by DCHD. In May 1999, the first SFT clinic was held and has continued with 12 clinics per year ever since. The coalition works closely with key members to assure the clinics are planned, organized, and successfully held in order to accomplish the goals of the SFT program.
In 2004, DCHD immunization coverage for 0-2years olds was 70.6%. The increase in up-to-date rates now ranks Deschutes County as 11th out of 36 counties. A collaborative and successful public awareness campaign was launched among media and marketing partners. Effective community networking occurred enhancing communication for this program and other medical events. Two additional counties in Oregon have since been trained to facilitate SFT clinics and have established the program in their communities. Over 6,500 children have been immunized at Central Oregon's SFT since 1999, thus reducing the number of children at risk of contracting vaccine preventable disease.  
The clinics are sustained using VFC/317 funded vaccine and are dependent on donations for supplies. Funds are collected from clients that do not qualify for free vaccine programs. Local Rotary clubs fiscally support the R.N. supervision required. An assortment of medically licensed and non-licensed volunteers is essential to the success of this program. DCHD has integrated SFT as part of its routine activities and has proven support by showing a 6 year history of success.