The COVID-19 pandemic caused significant disruption to the nation’s public health and healthcare infrastructure, in part due to inequitable vaccinations rates among the most vulnerable patient populations.

To help improve vaccine equity, the National Association of Community Health Centers, (NACHC) partnered with the Center for Care Innovations to apply lessons learned from COVID-19 to address flu and pneumococcal vaccines as well as other adult immunizations.

NACHC’s strategies during the 4th year of a national initiative to strengthen public health systems, including closing immunization gaps, included working with up to 10 primary care associations, health center-controlled networks (HCCNs), and up to 80 health centers to get more shots in arms by:

• Applying CDC Standards for Adult Immunization Practice • Working with states on Adult Immunization Programs • Harmonizing adult immunization service delivery with clinical and data workflows • Rolling out traditional and non-traditional partnerships • Working with health care extenders such as pharmacists and community health workers • Developing strategies to improve documentation of adult vaccinations and interoperability

By applying Human Centered Design (HCD), LEAN Informatics, and implementation science methods, NACHC’s proposal included a blended learning model using the following elements:

• Health Information Technology quality improvement, also known as HIT-informed quality improvement, working with health center networks and patient care assistants (PCAs) • Quality-improvement-focused learning community to share lessons learned and promising practices of health center teams • Documentation and data integrity • Patient-facing FHIR Apps to document vaccine status. (FHIR stands for Fast Healthcare Interoperability Resources; the FHIR standard defines how health care information can be exchanged between different computer systems, regardless of how it is stored). • Understanding and taking action on social determinants of health (SDOH) data to enhance clinical management of high-risk patients, improve health outcomes, and drive health equity

A collaborative approach that starts at point of care and builds on existing assets in the health center network will result in long-term cost savings, shared knowledge, patient and provider engagement, and increased coordination.

This program, designed to strengthen adult immunization practices in health centers serving high risk vulnerable populations, was supported by a federal initiative called the Strengthening Public Health Systems and Services through National Partnerships to Improve and Protect the Nation's Health.

During this program, the federal initiative was in its forth year of operation.