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Topics > Reducing Health Disparities Initiative > What We Are Doing > African-American Adults and Children Have Lower Rate of Immunization

African-American Adults and Children Have Lower Rate of Immunization

(Left) Erika Jenssen, Immunization Registry Coordinator
(Right) Guillermina Flores and Pati Delgado, staff at Dr. Jenkins' office, use the Immunization Registry

Immunization is among the most effective disease prevention measures known, yet immunization rates for African-American toddlers and adults are lower when compared to the rest of the population. An annual survey conducted by the State of California found that only 69% of African-American 2-year-olds met the recommended immunization schedule.

Contra Costa Health Plan (CCHP) found a significant immunization deficit for African-American two-year-olds. Among CCHP members the disparity is most pronounced for those with Contra Costa Regional Medical Center Primary Care Providers.

In 2002, African-Americans in the United States aged 65 and older were 30% less likely to have received the influenza (flu) shot in the past 12 months, and 40% less likely to have ever received the pneumonia shot, compared to non-Hispanic White adults of the same age group. (Data from the U.S. Department of Health and Human Services' Office of Minority Health)

Lower vaccination rates appear to be caused by lack of reminders for shots and appointments, frequent changes of telephone numbers and addresses, difficulty with transportation and childcare, and mistrust of the health care system. CCHS is working to address these issues.

Immunization Registry Seeks to Centralize Immunization Records

Increasing Immunizations for African-Americans

To reduce barriers for immunizations, especially for African-Americans, CCHP and the Contra Costa Regional Medical Center and Health Centers initiated the Good Health Check-Up Program to increase well-visits and immunizations for infants and toddlers.

Staff members identify children who are behind on well-visits and call to schedule a makeup appointment. CCHP members receive a followup letter and a reminder phone call and are offered a $10 gift certificate for keeping the appointment.

"The Good Health Check-up Program makes about 250 phone calls a month and about 75% of appointments made through this program are kept," said Ken Tilly, Director of Quality Management for the Health Plan. Because trust and transportation issues were among the barriers, we are also collaborating with senior centers all over Contra Costa to host flu clinics and enlisting African-American churches to help with educational efforts.

"People age 65 and older are at risk of dying from the flu, and getting a flu vaccine is the best way to prevent it. We want to reach all who are at increased risk," said Erika Jenssen, Immunization Registry Coordinator.

Specialized posters and cling-on decals are being sent to Public Health clinics, churches, senior centers and community-based organizations to help get the word out about the importance of flu vaccination.

Many children receive shots from multiple providers, making it difficult for providers and parents to track immunizations. The 10-year-old Contra Costa Automated Immunization Registry (CCAIR) is a computerized system that tracks immunization records for adults and children in Contra Costa.

Last year 90,828 immunizations for 30,874 patients were logged into CCAIR by our staff. Schools, community clinics and health care providers are being encouraged to join the registry. Because West Contra Costa historically has lower immunization rates than the rest of the county, efforts are being made to include the West Contra Costa Unified School District and MediCal providers in West County in the system. Our Child Health and Disability Prevention Program and CCHP are also working to reach MediCal providers to increase participation in the system.

WIC staff, along with Public Health, work with clients to verify that children are up-to-date on immunizations; they update the Immunization Registry and refer clients to providers if shots are missing. The system began as a pilot in Concord and, due to the dramatic improvement in immunization rates, has been expanded to all WIC sites. "The Registry is a great system and it works both during emergencies and on a day-to-day basis," said Erika Jenssen, Immunization Registry Coordinator.

"After Hurricane Katrina, many Louisiana children came to our county. We were granted access to Louisiana's Immunization Registry and were able to get children into school right away."

Send feedback about this story to Kate Fowlie at

Content provided by the Reducing Health Disparities Initiative.

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