1. Immunize LA Families Integration of Prenatal
Flu Immunization Education
and Tracking into a
South LA WIC Program
45th National Immunization Conference (NIC)
March 28 – 31st, 2010
Washington, DC

2. Acknowledgements Presenter: Terry Silberman, DrPH Co-Authors:
Jennifer Chiprich, PhD
Diane Gaspard, MA, RD
Lizz Romo, BS, RD
Akisha White, MPH
This project receives funding from the CDC Racial and Ethnic Approaches to Community Health REACH-US Initiative.
Institutional support is provided by the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center

3. Immunize LA Families
Immunize LA Families is a CDC funded REACH US Project (2007 – 2012)
Funded as Immunize LA Kids
under REACH 2010 (1999 – 2007)
Immunize LA Families is administered by South Los Angeles Health Projects, a community-based unit of LA BioMed

4. Immunize LA Families Coalition
IZLAF is a diverse coalition working towards improvement in lifespan immunization rates
Membership includes LA County Dept. of Public Health, local and state coalitions, medical & social service providers, community representatives
Focus on eliminating racial/ethnic disparities and increasing flu and pneumococcal immunization among older adults

5. Working towards Elimination of Racial/Ethnic Health Disparities
IZLAF is working to address inequities:
Access to healthcare
Education
Access to resources
(e.g., vaccinations)
Freedom from discrimination

6. Provider-based AFIX Intervention Faith-based and Community Outreach
Community Action Plan
Provider-based AFIX Intervention
Faith-based and
Community Outreach
WIC-Intervention
Social Media and Advocacy Efforts

7. LA BioMed/SLAHP WIC Program
SLAHP WIC serves nearly 100,000 participants at 10 WIC centers in South LA
Birth cohort of nearly 20,000 infants per yr
90 % Latino/a, 7 % African American
Monthly visits during pregnancy
One-on-one contact each trimester
Various health and nutrition topics

8. Immunization Services
SLAHP has conducted childhood IZ education and promotion at WIC continuously since the early 1990s
1997 introduced automated IZ tracking
2005 integrated use of local IZ registry
2008 began direct entry to California
Immunization Registry (CAIR)
By 2007 achieved 80 % UTD at 24 months

9. Prenatal Provider Survey
Targeted prenatal providers in SLAHP WIC service area
Self-administered survey
Telephone follow-up
Questions addressed:
provider immunization practices
cost to clients
IZ referrals

10. Prenatal Provider Survey Results
Response rate of 57% (63/110)
Less than half (46%) reported recommend flu vaccination to patients
Only 36% recommended flu vaccine to pregnant diabetic clients
56% reported they recommend flu vaccination to postpartum clients

11. Prenatal IZ Tracking at WIC
Intervention during flu season:
Flu IZ information/education/referral
- at all group education classes
- during one-on-one contacts
Tracking during one-on-one contacts
-reminder letters to pregnant diabetics
-documentation in WIC info system (ISIS)
- repeated follow-up during flu season
- generate reports to monitor results

12. Prenatal Tracking at WIC
Flu Season
Trained WIC staff
Launched intervention at two WIC centers
Initiated tracking and follow-up
2009 – 2010
Expanded to 6 WIC centers
2010 – 2011
- Expanded to all 10 SLAHP WIC centers

13. Results
Table 1. Percentage of prenatal/postpartum women reporting receipt of flu shots, 2008/09 and 2009/10, SLAHP WIC Program

14. Successes Improvement in those reporting flu IZ 9 % in 2008-2009
Education, tracking and referral of prenatal/postpartum women resulted in:
Improvement in those reporting flu IZ
9 % in
24 % in
Improvement in documentation from :
37 % in (two WIC centers)
73 % in (six WIC centers)

15. Limitations Implementation - WIC staff time - Adapted tracking system
- Documentation challenges
Measurement
- H1NI in 2009
- Self- reported IZ status

16. Sustainability Systems Change
Incorporated flu IZ question into WIC Nutrition questionnaires
- Prenatal/postpartum
Plan to continue intervention at all of the SLAHP WIC centers

17. Staff Immunization Campaign
Encourage all staff to get immunized
Statewide WIC contest
Agency-wide contest
I Choose campaign at WIC
Free flu immunizations for staff
Overall, 74% flu immunization coverage during the 2010/2011 flu season
In contrast to 60% during 2007/ 2008

18. I Choose Campaign

19. South Los Angeles Health Projects
Contact Information
Terry Silberman, DrPH
Lizz Romo, BS, RD
Akisha White, MPH
South Los Angeles Health Projects
Los Angeles BioMedical Research Institute at
Harbor-UCLA Medical Center