An Adult Immunization Best Practices Learning Collaborative: Impact, Scale Up, and Spread

Area of Science:

• Public Health
• Health Services Research
• Infectious Disease Prevention

Background:

• Adult vaccination rates for influenza and pneumococcal disease remain suboptimal in many healthcare settings.
• Learning collaborative models have shown promise in improving clinical processes and outcomes.
• Scaling up successful interventions is crucial for broad public health impact.

Purpose of the Study:

• To rapidly scale a proven learning collaborative intervention for adult vaccination across multiple US healthcare organizations.
• To examine the impact of this scaled intervention on adult immunization rates for influenza and pneumococcal disease.
• To assess the feasibility and effectiveness of disseminating a successful pilot program.

Main Methods:

• A comparative analysis using a difference-in-differences approach compared intervention and non-intervention propensity score-matched providers.
• Qualitative data from site visits and meetings were used to supplement quantitative findings.
• The intervention was scaled from 7 to 39 US healthcare organizations between 2014 and 2018.

Main Results:

• The scaled intervention demonstrated significant improvements in pneumococcal vaccination rates for patients aged ≥65 years (1.4%-3.7%) and high-risk patients aged 19-64 years (0.8%-1.6%).
• Significant increases were also observed in pneumococcal vaccinations for at-risk patients (1.7%) and influenza vaccinations (2.4%) in one cohort.
• Individual health systems reported even higher vaccination improvements, with rates up to 16.3% for specific vaccines.

Conclusions:

• A 7-site pilot learning collaborative intervention for adult vaccination was successfully scaled to 39 additional sites.
• The scaled intervention led to significant improvements in adult influenza and pneumococcal vaccination rates.
• The program resulted in an estimated 5.5 million additional adult vaccinations administered across 27 states between 2014 and 2018.