Increased spending on immunization infrastructure, access and services at local health departments is helping more people across the U.S. gain access to valuable vaccination services.


The nation’s more than 3,300 local health departments more than doubled their immunization spending in fiscal years of 2020 to 2021, according to a recent report from the National Association of County and City Health Officials. That influx allowed departments to expand vaccine access in their communities, with a 34% increase in vaccine outreach efforts.


Departments used a variety of routes to increase access. Some chose to expand the times when communities could access vaccines, with 41% of departments reporting an increase in their hours of operation. Additionally, 42% of departments expanded the availability of vaccines in community settings, including the use of mobile clinics and school-based vaccine clinics. Social media became a crucial tool for vaccine outreach as well, with 90% of health departments using it for outreach in 2023 compared to 67% in 2017.A doctor vaccinates a child


The doubling of immunization spending boosted COVID-19 vaccination work, according to the June report. In 2022, 93% of departments provided COVID-19 vaccines to adults and 87% provided them to children. Vaccines provided in 2022 also included those for influenza, mpox and childhood diseases.


The improvements in outreach and expansions in clinic functions have occurred in the midst of significant immunization workforce constraints in local health departments. Half of the departments reported that immunization service work has been affected by limitations in staffing. The limits in workforce availability are crucial to address, as more staff are necessary for immunization services now than in 2017, the report said.


Another major component of vaccine outreach efforts by local health departments is combating ongoing vaccine hesitancy within communities, which is fueled by misinformation. Dedicating resources to making educational resources more accessible and building trusting relationships between health care organizations and community members remains a growing effort, is crucial, according to NACCHO Chief Executive Officer Lori Tremmel Freeman, MBA.


“Working in the community with community-based organizations, with our health care partners, with schools is really how to change the trending that we are seeing,” Freeman told The Nation’s Health. “One component of addressing vaccine hesitancy that came out of this survey that is equally concerning is that hesitancy is spreading to health care providers, and local health departments. So even within the health field, there is a lot of work to do.”


Strengthening immunization data capacity is crucial to reaching under-vaccinated populations, the report said. More than half of departments still maintain immunization records and vaccine inventory on paper, making it increasingly difficult to share this information quickly and effectively. In fact, 41% of departments said that difficulty sharing such data with other jurisdictions is a key barrier in their work.


Other barriers to providing immunization services that were reported included lack of government support, limited staffing, confusion about recommendations and not enough language translation services.



Photo by Drazen Zigic, courtesy iStockphoto